Arabic 101c Registration From
A'oodhu billaahi minash-Shaytaanir-Rajeem. Bismillaahir-Rahmaanir-Raheem.
"We have sent it down as an Arabic Qur'an, in order that ye may learn wisdom." (Surah 12 Ayah 2)
As-Salaamu 'alaykum wa Rahmatullaah. Please complete this form in its entirety.
Cell Phone Number
Age 18 or older?
The tuition for this class is $20 per month, payable on the 1st of each month. (No payment information will be collected at this time. God willing, someone from the office will be in touch with you to process payment.)
Please choose from one of the payment options below.
Automatic withdrawals from my credit/debit card or bank account on the 1st of every month. (Preferred)
Payment in in cash or check of at least three (3) months at a time, in advance. (Anyone choosing this payment method who fails to remit payment on time more than once will be required to setup automatic withdrawals from that point forward.)
Terms & Conditions
Any student who wishes to withdraw from the class must submit an email request to the office (
) at least 14 calendar days prior to the desired withdrawal date. There will be no refunds for tuition fees already paid.
I understand and agree to all the terms herein.
Please consider donating $10 or $20 towards General Masjid Operations, which will also be automatically withdrawn monthly, but categorized as a tax-deductible donation, instead of tuition:
I do not wish to donate.
I would like to donate $10 per month towards General Masjid Operations.
I would like to donate $20 per month towards General Masjid Operations.
If you would like to donate a different monthly amount monthly, please enter that amount below.
By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
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