Ghamidi Center of Islamic Learning

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Financial Aid Form for Educational Courses

Email *

Application Information

Please complete all sections. Please note that incomplete applications will not be considered. Parents may fill out the form for their minor children. One form is required for each child. Please note that we are a non-profit organization with limited resources. Please only fill out the form if you feel that you deserve the aid.

Last Name *

First Name *

Middle Name

Student Full Name (if parent filling out the form)

Street Address *

Apartment/Unit No

City *

State/Province *

Zip/Postal Code *

Student Email Address *

Country of Residence *

Are there any legal restrictions in your country to enroll for this program? *

Yes

What is your annual household income? *

How many members are in your family? *

Have you recently converted to Islam? *

Yes

I converted a long time ago

I am a born Muslim

Would you like to be considered for interest free loan? *

Yes

If yes, then how would you like to pay back ? (For Volunteering/Community Service GCIL will decide about the program)

Volunteering

Community Service

Pay back later cash

Other:

Clear selection

What are you requesting financial assistance for? Please be very specific. If a class or a course, specify the exact name, section, and code found on our web site. If assistance is for a book or another resource please specify the exact name, title, SKU or other identifying information. *

Any other information that would help us to narrow down the exact specifics you provided above *

What is the length or duration of of the requested assistance? If for a class or a course, please specify the duration as of the length of that class or course. If for any other resource please provide the best estimate in your judgement. *

Requested start date of assistance *

YYYY

What is the advertised price/ fee of what you need assistance with? *

How will attending the requested class / course or using the requested resource help you in your life? The more specific details you provide the better. *

Education Background

What is your highest level of Education?

What are your life goals and how would this Financial Aid help you? *

Please list any references that you would like to provide. Please include their email address one per line.

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application or interview may result in termination of Financial Aid and I may be required to pay back any amount awarded. I understand that in case of arbitration GCIL decision will be binding to all parties. Parents/Guardian should sign if application is under 18 years old.

By Selection "I Agree" I provide my consent to the above statement. *

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