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Youth Qur'an Registration
15
Questions
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1
Parents Name
Contact - mother, father, or guardian
First Name
Last Name
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2
Email
*
This field is required.
example@example.com
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3
Phone Number
*
This field is required.
Area Code
Phone Number
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4
Child's Name
*
This field is required.
First Name
Last Name
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5
Child's Gender
*
This field is required.
Male
Female
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6
Child's Age
*
This field is required.
Please enter a valid age greater than zero
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7
Please select the program you would like to enroll your child in:
Quran Memorization
Quran Nazirah
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8
Is your child a special needs student?
*
This field is required.
YES
NO
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9
Has he/she learned the Arabic alphabet/basic rules and started reading Qur'an?
*
This field is required.
YES
NO
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10
Has he/she finished 1 whole Qur'an yet?
*
This field is required.
Beginning to end. Able to now read clearly at a steady pace even though there may be tajweed mistakes.
YES
NO
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11
How many surahs has he/she memorized?
*
This field is required.
0-10
Whole 30th Juz'/Para
30th + other longer surahs
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12
Has he/she been formally taught tajweed before?
*
This field is required.
Correct pronunciation of the letters and rules of recitation
YES
NO
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13
Please select half hour time slot
*
This field is required.
4-4.30
4.30-5
5-5.30
5.30-6
6-6.30
6.30-7
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14
Does your child have any difficulty focusing and following instructions?
*
This field is required.
Gets easily distracted
Sometimes
Very rarely
No issues
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15
Do you agree to help monitor your child while he/she is online for class, and make sure their assignments are complete outside of class?
Parent participation is always extremely important for any child to progress.
YES
NO
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