TISONA MUSLIM YOUTH MENTORING

TISONA MUSLIM YOUTH MENTORING

REGISTRATION FORM

*Required
How many children would like to enroll?*

One child2 children3 children4 children5 Children
Parent's full name*
Parent's Phone Number*
Parent's Email Address*
Parent's city and state*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student's full name*
Student's age*
Student's Gender*
Second Student's full name*
Second Student's age*
Second Student's Gender*
Third Student's full name*
Third Student's age*
Third Student's Gender*
Fourth Student's full name*
Fourth Student's age*
Fourth Student's Gender*
Fifth Student's full name
Fifth Student's age*
Fifth Student's Gender*
Suggested monthly fees

40 USD50 USD60 USDOther Amount
Suggested monthly fees

50 USD80 USD100 USDOther Amount
Suggested monthly fees

60 USD90 USD120 USDOther Amount
Suggested monthly fees

70 USD100 USD130 USDOther Amount
Suggested monthly fees

80 USD120 USD150 USDOther Amount
For sponsoring a scholarship please contact us throgh our email Tisona@tisona.org
Write any other information that you would like to let us know (Optional)
By filling and sending back this form, I agree and authorize my child/children to participate in Tisona Madrasa programs and I understand that Tisona holds all rights to except or deny any application upon review of my application.
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