Swansea Mosque Islamic Academy
Males
Student Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Post Code
Parent/Guardian Name
First Name
Last Name
Student/Parent Email
*
example@example.com
Same Address As Student?
Yes
No
Address of Fees Payer
Street Address
Street Address Line 2
City
State / Province
Post Code
Student/Parent Phone Number
*
Please enter a valid phone number.
Subscription
*
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Academy Online Classes
Online Classes
£
20.00
GBP
for each
month
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