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Course Registration Form

Student's Details
Student's First Name(*)
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Student's Surname(*)
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Gender(*)
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Date of Birth(*)
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Age(*)
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House number/Street(*)

Town/City(*)
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Post/Zip Code(*)
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Country(*)
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Landline(*)

Mobile Number(*)
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E-mail(*)
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Skype ID(*)
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Parents/Gaurdians Details for students Under 18 years of age
First Name(*)
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Surname(*)
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House number/Street(*)

Town/City(*)
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Post/Zip Code(*)
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Country(*)
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Landline(*)

Mobile Number(*)
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E-mail(*)
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Course Information
Select the Course(*)
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Is applicant currently studying with some one?(*)
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Whom is applicant studying with?(*)
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Applicant's level @ the subject(*)
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Why do you want to study with Al-Itqaan(*)
Mandatory Field

PREFERRED DAYS & TIME: SHOULD BE AT LEAST TWO WEEKS FROM NOW Hrs per week For Arabic: 2 days : 1.5 hrs each Quran : 4 days 0.5 hrs each or 2 days 1 hr each. NOTE: Teachers are based in Egypt. UK time you select will have to change in Summer/Winter as teacher's time will remain the same.
Preferred Days and Time (Example: Monday - 09:00)(*)
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Preferred Start Date(*)
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Additional Information
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TERMS AND CONDITIONS Each Conditions should be accepted by selecting the radio button
Admission:(*)
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Observation(*)
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Classes(*)
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Issue Reporting(*)
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Class Alerations(*)
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Deposit(*)
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Teacher Interaction(*)
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Payments(*)
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Mobile Phones(*)
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REPORTING CANCELLATIONS.
Cancellation Form(*)
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Under 24 Hrs(*)
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Absenteeism(*)
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Valid Reasons(*)
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Terms and Conditions Acceptance(*)
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How did you hear of us?(*)
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Can you afford to pay?(*)
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How much can you contribute?(*)
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Reasons for subsidy(*)
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Captcha(*)
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