Youth Qur'an Registration

1

Parents Name Contact - mother, father, or guardian

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Child's Name* This field is required.

First Name

Last Name

5

Child's Gender* This field is required.

Male

Female

6

Child's Age* This field is required.

Ages 6 and above only

7

Please select the program you would like to enroll your child in:

Quran Memorization

Quran Nazirah

8

Is your child a special needs student?* This field is required.

YESNO

9

Has he/she learned the Arabic alphabet/basic rules and started reading Qur'an?* This field is required.

YESNO

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.

YESNO

11

How many surahs has he/she memorized?* This field is required.

0-10

Whole 30th Juz'/Para

30th + other longer surahs

12

Has he/she been formally taught tajweed before?* This field is required.Correct pronunciation of the letters and rules of recitation

YESNO

14

Does your child have any difficulty focusing and following instructions?* This field is required.

Gets easily distracted

Sometimes

Very rarely

No issues

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.

YESNO