Rahma Center Quran Institute Registration Form- Session 2 with Imam Anas
Thank you for your interest in enrolling your child in Rahma Center's Quran Institute. Quran classes are offered onsite on Mondays & Wednesdays OR Tuesdays & Thursdays. Classes in the 2024-2025 academic year will begin in the week of August 19, 2024, until the week of May 26, 2025.
Please read the following information before proceeding. Enrollment Policy: Complete this registration form for each student to be enrolled between the ages of 6 to 15 years. The fees include $50 for registration, $50 for supplies and a monthly tuition of $200 per student. Monthly tuition of $200 is due by the 3rd day of each month. Please note that information for tuition assistance can be found in the Tuition, Registration & Supplies Payment section. All fees paid to RC are non-refundable. In the event of a cancellation, you may request that your payment be converted to a tax-deductible donation. Rahma Center reserves the right to disenroll students at its discretion. Release and Waiver of Liability (https://therahmacenter.org/releaseandwaiver/).
Student's Full Name
*
Student's Gender
*
Male
Female
Student's Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
What grade is the student in for the 2024-2025 school year?
First grade
Second grade
Third grade
Fourth grade
Fifth grade
Sixth grade
Seventh - Tenth grade
Parent's First Name
*
Parent's Last Name
*
Parent's Phone Number
*
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email Address
*
Parent's Email Address
*
example@example.com
Relationship to Student
*
Mother
Father
Home Street Address
*
Home City
*
Home Zipcode
*
Emergency Contact Full Name
*
Emergency Contact Phone Number
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Emergency Contact Email Address
*
Emergency Contact Email Address
*
example@example.com
Relationship to Student
*
Mother
Father
Is the Person Listed as the Emergency Contact Allowed to Pick up/Drop off the Student?
*
Yes
No
Other Individual Allowed to Pick up/Drop off the Student
Other Individual's Phone Number
Other Individual's Phone Number
Please enter a valid phone number.
Relationship to Student
Mother
Father
Other
Session Days
*
Mondays & Wednesdays
Session Time:
*
5:40 PM - 7:15 PM
Release and Waiver of Liability (https://therahmacenter.org/releaseandwaiver/)
*
I agree to the terms of the Release and Waiver of Liability
Back
Next
Tuition, Registration & Supplies Payment
Are you in need of financial aid? [Please note that you will need to submit the full payment and any fee adjustments will be made upon application approval. Please contact the office for more details at office@therahmacenter.org or (949)989-2351].
Yes
No
Total Fees (Tuition $200, Registration Fee $50 & Supplies $50). All fees paid to RC are non-refundable. In the event of a cancellation, you may request that your payment be converted to a tax-deductible donation.
*
prev
next
( X )
USD
QI
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Submit
Should be Empty: