Application for Quran Reading Program
Deadline to apply for our Quran Reading program is May 29, 2026. Please note that your application does not guarantee your admission. A member of our team will follow up to discuss the status of your application.
Name of Student
*
First Name
Last Name
Date of Birth:
*
/
Month
/
Day
Year
Applicants must be at least 8 years of age to enroll in this program.
Gender
*
Male
Female
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If student is a minor
please complete the following section with the parent or guardian’s information.
Parent 1 Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Parent 2 or Emergency Contact Name
*
First Name
Last Name
Relationship to Student
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Application Questions
Preferred days of Session
*
Mondays and Wednesdays
Tuesdays and Thursdays
Can you read from the Quran?
*
Yes
No
Other
Please describe your level of proficiency and comfort when reading the Quran while looking at the mushaf text
Are you able to read and write in Arabic?
*
Yes, fluently
Yes, but slowly/with difficulty
No, not yet
Other
Where did you complete your Quran and/or Arabic studies?
Please list the names of your teachers (if applicable).
How did you hear about the Quran Reading Program?
Existing student or parent referral
Internet search
Social Media
Friend referral
Other
Thank you for registering for our Quran Reading Program. A member of our team will contact you shortly with the next steps.
Jazak Allahu Khayran!
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