Arabic Summer School Registration 2019
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Email *
Parent Name *
Last, First
Contact e-mail *
email@domain.ext
Contact phone *
(xxx) xxx-xxxx
Emergency contact *
(xxx) xxx-xxxx
Emergency contact person *
Last, First
Child 1 *
Last, first name
Child 1 gender *
Child 1 date of birth *
MM
/
DD
/
YYYY
At what grade your child 1 is currently in? (Example: KG, Grade 1, 2, 3 4 and so on) *
At what level in the Arabic School your child 1 was? (Example: Level 1, 2, 3, 4 or "new" for  new students) *
Child 2
Last, first name
Child 2 gender
Clear selection
Child 2 date of birth
MM
/
DD
/
YYYY
At what grade your child 2 is currently in? (Example: KG, Grade 1, 2, 3 4 and so on)
At what level in the Arabic School your child 2 was? (Example: Level 1, 2, 3, 4 or place "new" for new students)
Child 3
Last, first name
Child 3 gender
Clear selection
Child 3 date of birth
MM
/
DD
/
YYYY
At what grade your child 3 is currently in? (Example: KG, Grade 1, 2, 3 4 and so on)
At what level in the Arabic School your child 3 was? (Example: Level 1, 2, 3, 4 or "new" for new students)
Is there any medical condition for any of your children that the school administration should know of? i. e. allergies , ext. *
If you answered the previous question with "Yes" please describe in details below
Have you read and agreed to the rules and polices of the school as outlined on the webpage: https://www.mcemosque.com/summer-school *
A copy of your responses will be emailed to the address you provided.
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