Adult Urdu Course Annual Registration Form 2020

Please pay the term fees by visting before completing this form.
If you experience any technical difficulities in completing this registration form please contact Saira 07780361901.
Student Full Name *
Date of Birth e.g. 1/4/2003 *
Address *
Contact Number *
Emergency Contact Name and Number *
Any important dietary or medical information? *
Name of Doctor *
Doctor Address *
Doctor Contact Number *
Select which course(s) you are registering for. *
Provide the payee name as it appears on Paypal or Bank account? *
Any additional comments for the admin team e.g. paying from someone elses account, paying on behalf of another student etc
CONSENT FOR MEDICAL TREATMENT. I hereby consent to my recieving medical treatment, if the staff or doctor thinks it is necessary in the event of an emergancy, if contact or parent can not be reached. *
I agree to be photographed during class/events for use on the Al-Meezan website, social media and in publications for the duration of my attendance of the course. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy