Waitlist for EIC WIS: Youth
Thank you for your interest in EIC Weekend Islamic School for youth ages 12-18 years. Registration deadline was June 15, 2019, therefore the registration is now closed. However, please add your child to the waitlist and we will contact you if there is an opening before the first day of school in-shaa-Allah.
Email address *
Student's Full Name *
Your answer
Gender *
Current Age *
EIC WIS Youth is for ages 12 - 18 years.
Your answer
Birthdate *
format: mm/dd/yyyy
Your answer
Home Address *
format: street address, city, zip code
Your answer
Father's Full Name *
Your answer
Father's Email Address *
Your answer
Father's Mobile Number *
Please include area code
Your answer
Mother's Full Name *
Your answer
Mother's Email Address *
Your answer
Mother's Mobile Number *
Please include area code
Your answer
Questions/Comments
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A copy of your responses will be emailed to the address you provided.
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