Pupil's First Name *

Pupil's Second Name *

Sex *
-- Select -- Male Female

How old is the learner *

Date of Submission

Guardian Name *

WhatsApp Number *

Guardian Email *
This email will be used to send you live schedule updates and all Quran study information.

Level of Arabic reading
Beginner Basic understanding

Pupil's Home Country

Guardian Remarks

Has your child previously attended Quran/theology classes? *
-- Select -- Yes No

If yes, briefly describe previous learning:

Any additional information?

Select Class Package:
-- Choose a class package -- 1 Hour Weekly (4 hrs/month) – $25/month 2 Hours Weekly (8 hrs/month) – $50/month