Appointment Request Form

Ummul Qura Islamic School (UQIS)

6005 Chapman Rd, Building B, Watauga TX 76148
Assalamu Alaikum Brother/Sister. Please fill this form and make an appointment with us and also bring your child. We will make a decision and finish the application process InshaAllah.

(for the new student administration, it is required to bring your kids)
Note: April 22 & 23, appointments are available online only.
See the program details
Student admission & information about it.Other
New StudentExisting Student
How many children do you want to admit to UQIS?*
Student Name*
Who is coming?*
Student 1*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Student 2*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Student 3*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Student 4*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Student 5*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Student 6*

First NameMiddle NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Date
Your Name *

First NameLast Name
Legal Guardian's Full Name (for under 18)

First NameMiddle NameLast Name
Contact Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Full-time Islamic schoolFull-time Hifz With AcademicAfter School Quran and Islamic Studies ProgramSummer Intensive Program
"WE WILL PROVIDE FINANCIAL AID TO ELIGIBLE STUDENTS"
What date and time works best for you?*
If you have any questions regarding the school, please mention below.
Jazakallahu Khairan. We will answer the questions when you meet with us.
YesNo
Email
example@example.com
Should be Empty:

Ummul Qura Islamic School (UQIS)

Assalamu Alaikum Brother/Sister. Please fill this form and make an appointment with us and also bring your child. We will make a decision and finish the application process InshaAllah.