Darul-Arqam Registration Form
444 Connecticut Street, Buffalo, NY, USA
amjad2usa@gmail.com
+1 203-722-9849
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Father Name
Mother Name
Email
Cell Phone *
Address *
City *
Emergency Contact Name *
Emergency Contact Number
Emergency Contact Relation *
I understand that I will have to pay $40.00 per student  between the date of 1-10 of every month. *
Required
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