ICB Student Registration Form
Student Registration Form
Parent\Guardian Name *
Adults students can put their own name here
Address *
Please provide full address including State, City and ZIP Code
Email *
Home Phone
Mobile Phone *
Emergency Contact Name *
Emergency Contact Number *
Relationship to Student *
Student Name(s) *
For multiple students, Please add Name, DOB, Gender and Program to enroll manually here
Student Date of Birth *
Gender *
Siblings Discounts
We provide siblings discounts for Weekday and Sunday School.

1. One Child 300 tuition fee and 50 books and registration
2. Two children 550 tuition fee and 100 books and registration fee
3. Three children 600 tuition fee and 150 registration fee
4. Four and above 150/child tuition fee and 50/child books and registration fee
Program to Enroll *
For siblings we provide discounts.
Do student have any of the following (check all that apply) *
Payment Plan *
If you cannot pay the student fee, please select Zakaat, We can arrange it by Zakaat collection on your behalf.
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