Masjid Al- Rasheed Girls Hifz Program Registration Form

Masjid Al- Rasheed Girls Hifz Program Registration Form

Please fill out your details to register for after-school Hifz Program.
Monday-Thursday 5-7PM Friday 5-6PM
Students Information
Student's Full Name

First NameLast Name
Student's Date of Birth ( Children MUST be at least 7 Years old )

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Guardian's Information
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are there any allergies, medical conditions, or special instructions we should be aware of?
ONLY RECURRING PAYMENTS ACEPTED

To make tuition payments more convenient, all fees will now be collected through recurring payments. You will be contacted after registration with instructions to complete your payment setup.
Should be Empty:

Students Information