Sunday Islamic School Registration Form

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Sunday Islamic School Registration Form

Masjid Wali Hasan

1635 Huston Drive

Decatur, IL 63526

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* Indicates required question

Child 1 Full Name , Date of birth and Age
*

Your answer

Child 2 Full Name ,Date of birth and Age

Your answer

Child 3 Full Name Date of birth and Age

Your answer

Child 4 Full Name, Date of birth and Age

Your answer

Mother's Full Name
*

Your answer

Father's Full Name

Your answer

Address
*

Your answer

Home Phone Number
*

Your answer

Emergency Contact 1 (#) and Relation To Student (s)
*

Your answer

Emergency Contact 2 (#) and Relation to student (s)

Your answer

New or Returning Student(s)
*

New student (s)

Returning student (s)

Fee- $50 per child
*

Will pay

Request to be waived

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