Admissions Form (Al-Hikmah center)

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Admissions Form (Al-Hikmah center)

If you are interested in joining Al-hikmah center fill in the below form and someone will contact you shortly after.

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* Indicates required question

Email *

Your email

Students first and last name *

Your answer

Age *

MM

/

DD

/

YYYY

Gender *

Male

Female

Students contact info *

Your answer

Does the student have any health complications? if yes what are they? *

Your answer

Father's first and last name (If applicable) *

Your answer

Father's Contact Info

Your answer

Mother's first and last name (If applicable)

Your answer

Mother's Contact Info

Your answer

Preferred person of contact *

Mother

Father

Student

How did you hear about Al-Hikmah Center? *

Your answer

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