MASJID NOOR LONG ISLAND
11032 Park Ave, Huntington, NY 11743
feedback@masjidnoorli.net
www.masjidnoorli.net
(631) 683-4185
Noor Full-Time Hifz Program
7:45 AM - 1:30PM Bayan Academy
Participant Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parents Mobile Number
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Parents Email
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Date of Birth
*
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Month
-
Day
Year
Date
School Grade
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
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