TA Programs Registration

1
Select preferred course* This field is required.
Islam360 - (Sundays $65)
Islam360 - (Saturdays $65)
Youth Group (Sundays $65)
Adult Quran - 2days/week ($115)
Weekday Quran Program (2 days $70)
Weekend Quran Program (2 days $70)
Jr. Weekday Quran (2 days $70)
Jr. Weekend Quran (2 days $70)
Online Quran (2 days $70)
Sat Islamic School ($95)
Sun Islamic School ($95)
Part-time Quran memorization ($195)
Private Quran - 1day/week 30min ($95)
Private Quran - 2days/week 15min ($95)
Private Quran - 2days/week 30min ($165)
If you wish to register for multiple program, please list additional programs in comment section below.
2
Please indicate whether you prefer your child to attend classes on-site or online?* This field is required.
In-Person Learning
Online Learning
3
Calculation
4
Please select which day you prefer for the Islam360* This field is required.
Saturday
Sunday
5
Student Name* This field is required.
First Name
Last Name
6
Date of Birth* This field is required.
Date
Day
Month
Year
7
Current age of the enrolling student: age *
8
Gender* This field is required.
Male
Female
9
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Canada
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
10
Home Phone
Area Code
Phone Number
11
Father* This field is required.
First Name
Last Name
12
Father Mobile* This field is required.
13
Father Email* This field is required.
14
Mother* This field is required.
First Name
Last Name
15
Mother Mobile* This field is required.
16
Mother Email* This field is required.
17
Have you previously enrolled in our program?* This field is required.
Please Select
Please Select
Yes
No
18
CommentsPreferred Time/Days, Areas of Improvement for the student
19
Agreement & Withdrawal Policy:

By registering, you agree to follow institute policies and release Tarbiyah Academy and its staff from liability for any injury or incident arising during participation.

Islamic Studies: A full-term notice or payment is required for withdrawal.
Other Programs: One month’s notice via email is required. Withdrawals take effect in the next billing cycle; no last-minute cancellations or refunds.
Behavioral Dismissal: No refund will be issued if a student is removed due to misconduct.

All policies apply to both online and in-person programs.
20
Social Media Consent* This field is required.
Yes, I consent to my child being filmed, interviewed, audio recorded, videotaped, or photographed by school employees or agents during the academic school year, to be placed on the website and/or school social media.
No, I do NOT consent to my child being filmed, interviewed, audio recorded, videotaped, or photographed by school employees or agents during the academic school year, to be placed on the website and/or school social media.
21
Parent's Signature* This field is required.I acknowledge and agree to the terms, conditions, and withdrawal policies of Tarbiyah Academy.
Clear
22
Please proceed with the paymentTA Registration
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