MIA After School Qur'an Program Registration
After-School Qur'an Reading (Nazirah) & Hifz

First Day of Class: Monday, Sept. 11, 2017
Last Day of Class: Friday, May 17, 2018

Classes are held Monday through Thursday. Students can attend 4 days or 2 days a week.
- 4 days - Monday through Thursday - $80 / month*
- 2 days - Monday and Wednesday - $60 / month*
- 2 days - Tuesday and Thursday - $60 / month*

Students can register to attend one of the following sessions.
Session 1: 4:15pm - 5:30pm
Session 2: 5:30pm - 6:45pm
Both Sessions (Hifz Only): 4:15pm - 6:45pm (additional $20 / month)

IMPORTANT: Registration is not considered complete until initial payment has been made online at the following link or at the masjid kiosk.

* Financial Assistance & payment plans available upon request

Hifz Students must meet the following criteria:
- At least 7 years old
- Able to read the Qur’an fluently
- Student MUST have the willingness and passion to memorize the Quran

Qur’an Reading Program
- Designed for all levels wishing to learn proper Qur’an reading & recitation
- Must be at least 5 years old and able to sit & learn
Email address *
Which Program are you registering for? *
First and Last Name of Student *
Your answer
Age of student on Sept 10, 2017 *
Your answer
Gender *
How fluent is the student in reading the Qur'an? *
How many Juz' does the student have memorized?
Your answer
Which Days will the student be attending? *
Which session will the student be attending?
Name of Parent *
Your answer
City of Residence *
Your answer
Mobile Phone number of Parent *
Your answer
Additional Local Emergency Contact (Name & Number) *
Your answer
Additional Notes or Comments
Your answer
Disclaimer *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy