ICMC Weekend Islamic School Registration Form

ICMC Weekend School Registration Form

Parents Information

Father's Name*

Father's Phone*

Father's Email*

Mother's Name*

Mother's Phone*

Mother's Email*

Street Address*

Address Line 2

City*

Zipcode*

State*

Are you registering for Muhsen ?

How many Students are you registering?

Please select students count to add more students.

Child 1 - Name*

Age*

Grade Level*

Child 2 - Name*

Age*

Grade Level*

Child 3 - Name*

Age*

Grade Level*

Child 4 - Name*

Age*

Grade Level*

The deposit is only to secure the admission of the student. Once a decision has been made regarding the admission, we will update the fees.

Deposit to secure admission*

Deposit - $100

Students Total

You are authorizing to pay the below amount for ICMC Weekend school and Donation/Sponsoring.

Choose your payment option:*

CheckCredit CardVenmo (@icmc-ws)

Total Amount to be paid (Check):

USD

Total Amount to be paid (Credit Card):

USD

Total Amount to be paid (Venmo):

USD