Jamiah Qasimul Uloom Islamic Fundamentals Course Application Form
3482 Lawrence Ave. E, 2 nd floor, Unit 208, Scarborough, ON.,  M1H 3E5 - (416) 431-2589
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Applicant Information:
First Name *
Last Name *
Address *
City *
Postal/Zip Code
Phone Number *
Email *
Date of Birth *
Place of Birth *
Current School Grade
Parents/Guardian Information
Full Name *
Address (If different from above)
Postal/Zip Code
Phone Number *
Email *
Required Documents:
Please provide all the required documents listed below. Application will only be processed once we
have received all documents:

          1. Health Card
          2. Copy of government issued ID

The information we have given on this form is true and accurate to the best of our knowledge.
We understand that our application will be terminated if we have knowingly given false information.
(Applicant to sign if above 16)
Disclaimer and Signature *
I understand and agree that Jamiah Qasimul Uloom and its staff will not be held responsible due to any unfortunate event, such as personal injury or accident, my child faces during school hours. Registration fees of $100 (books included) is applicable to all students. Monthly fees are to be given at the first of every month.
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