NUI Maktab Student Registration Form
Terms and Conditions 

• Please complete one form for each child 

• Class schedule is Monday to Friday, 5:00 pm to 7:00 pm 

• Monthly Tuition: 1st Child $60 – Two Children $ 110 – Three children $150 

• $30 Book fee/ per child is due at the time of enrollment. (first month's tuition will include the monthly tuition + book fee).

•Preferred method of payment is via Zelle. All payments should be sent to finance@nidaulislam.org with payment/student details noted in the memo. If writing a check, make payable to Nida ul Islam - In memo section write 'Maktab Tuition' with name of the student/students 

• All school rules in written or other form must be always adhered to

• Dress Code: No Jewelry on brothers. No Shorts. No hats/ or baseball caps. No dresses with images of people or animals. Brothers and sisters to dress appropriately in the spirit of modesty and humility to Allah (SWT). 

• Discipline: No Cell phones, Chewing gums. No harassing fellow students or teacher/instructor. No indecent language and images to be spoken, drawn or written. Any violation of these or other rules of NUI and the MAKTAB PROGRAM will warrant a warning and if necessary, suspension at the decision of the Imam and the administration. 

• Punctuality: Parents must bring students at least five minutes before Maktab commences and pick five minutes after Maktab time finishes.  

The program fees and timings are subject to change

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STUDENT INFORMATION
First and Last Name
 *
Gender *
Date of Birth *
MM
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DD
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YYYY
Home Address *
City *
State *
Zip *
PARENT/GUARDIAN INFORMATION
Please provide your information in case of an emergency and inform the program administrator immediately if there is any change in the information provided
Father's Name
 *
Father's Cell Phone *
Number will be added to the program's WhatsApp group for all communication and reminders
Mother's Name
 *
Mother's Cell Phone
 *
Number will be added to the program's WhatsApp group for all communication and reminders
Email Address
 *
Please provide preferred email address to receive communication from Nida-Ul-Islam
MEDICAL HISTORY
Does your child have any existing medical condition that requires special attention? If yes, Please explain
 *
Does your child have any Allergies that the school should be aware off? If yes, please explain
 *
Is your child currently on any medications? If yes, please list them
 *
EMERGENCY CONTACT
Please provide information of a relative or friend not residing with you 
Name 
 *
Phone/Cell number
 *
Home address (street, city, state, zip code)
 *
Child's Doctor's Name
 *
Child's Doctor's Phone Number 
 *
EDUCATION
Child's current grade in school
 *
Which program are you enrolling your child for?
 *
What is your child's level of reading of the Qur'anic, Arabic, text?
 *
Knowledge of Islam your child displays
 *
ELECTRONIC SIGNATURE
Nida-Ul-Islam or its board members and other representatives of the Masjid are not to be held responsible for any incident or accident that may occur within the premises, during or before and after program hours. Parents/ Guardians are responsible for prompt drop off and pick up. The school will not facilitate any supervision other than the program hours. Students are responsible for their own belongings. The Masjid will not be responsible for lost items.
Parent/Guardian Signature
 *
The electronic signature below and its related fields are treated by the Academy of Saut Ul Furqan like a physical handwritten signature on a paper form. 
Date
 *
MM
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DD
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YYYY
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