Hadi Institute Leadership Program | Registration
Salamun Alakuim, please email info@hadinstitute.com or call 313-949-9293 with any questions! Someone will be in touch after the form is submitted!

Please complete this form entirely! We look forward to working with you and your family.

REGISTRATION IS OPEN ONLY FOR STUDENTS IN 8TH GRADE TO 12TH GRADE THAT RESIDE IN THE UNITED STATES.

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Parent/Guardian Name *
Parent's Phone Number *
Parent's Email Address *
Number of Children *
Student 1 First Name *
Student 1 Last Name *
Gender *
Date of Birth *
Current School Grade *
Student 2 First Name
Student 2 Last Name
Gender
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Student  3 Last Name
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Student 4 First Name
Student 4 Last Name
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