Please enable JavaScript in your browser to complete this form.Register - Step 1 of 2STUDENT INFORMATIONStudent 1Student Name *FirstLastSex *MaleFemaleCurrent Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNew Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunAdd AnotherAdd Another StudentCheck this box if you want to add more students, otherwise just click on NEXT button.Student 2Student Name *FirstLastSex *MaleFemaleCurrent Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNew Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunAdd Another 2Add Another StudentCheck this box if you want to add more studentsStudent 3Student Name *FirstLastSex *MaleFemaleCurrent Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNew Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunAdd Another 3Add Another StudentCheck this box if you want to add more studentsStudent 4Student Name *FirstLastSex *MaleFemaleCurrent Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNew Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunAdd Another 4Add Another StudentCheck this box if you want to add more studentsStudent 5Student Name *FirstLastSex *MaleFemaleCurrent Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNew Session *1A: Reading Mon-Thu 4:00 to 6:30 PM2A: Reading Sat-Sun 1:00 to 4:00 PMHIFZ: Mon-Thu and Sat-SunNextFAMILY INFORMATIONParent / Guardian Name *Email *EmailConfirm EmailPrimary cell phone number *Alternate cell phone numberStreet Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeTotal Monthly Deduction Amount New *If the change of session affects your total monthly tuition, then we will adjust the amount from next month. Hifz is $80/month for first child. $75/month for each additional child. Reading Weekdays is $50/month for first child. $45/month for each additional child. Reading Weekends is $40/month for first child. $35/month for each additional child. Calculate the total amount for your case and enter it here. This will be the monthly auto-deduction from your account. This amount is for your reference only. Administration will calculate the correct amount if you have entered wrong amount here. We will stop auto-deduction when we receive the withdrawal form, when you leave the program in future. PreviousWebsiteSubmit
