Madina Institute Deen Academy Registration
Please fill out one form per student.
Classes start Aug 20, 2017.
For children grade 3 - high school
Seats are limited - must submit your first fee installment at Madina Institute to reserve your spot.
Email address
Student Name
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Student's grade in school
Your answer
Student Home Address
Your answer
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