Masjid Noor Ul Huda

  • May 2020
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TUTORING CLASSES 

REGISTRATION AND ADMISSION FORM  PLEASE PRINT CLEARLY AND USE ADDITIONAL FORM FOR MORE THAN THREE CHILDREN 

  STUDENT # 1 NAME: _____________________________________ AGE: ________ SEX: M / F   GRADE: _________  STUDENT # 2 NAME: _____________________________________ AGE: ________ SEX: M / F   GRADE: _________  STUDENT # 3 NAME: _____________________________________ AGE: ________ SEX: M / F   GRADE: _________    ADDRESS: ____________________________________________________________________________________  PARENT’S/GUARDIAN NAME: ____________________________________________________________________  HOME PHONE: _____________________WORK PHONE:_________________CELL PHONE:____________________  E‐MAIL ADDRESS: ______________________________________________________________________________    We the Parents/Guardians/Myself (undersigned) agree to abide by all the rules and regulations as specified out by  management, volunteers and teachers at the School. We also agree that ICC will not be responsible for any injury,  damage or loss of any kind which may occur in Masjid Noor‐Ul‐Huda Islamic Center on or around the property  involving any teacher, students, ICC officers, visitors, guests and/or volunteers. Parents are required to drop their  children and pick them after School time. If any reason the Parents cannot make it on time, please make an alternate  arrangement to pick up your child. Please inform the school management so they can let go your child with your  assigned person. 

___________________________________________________________________________  PARENT/GUARDIAN NAME                                    SIGNATURE                                                DATE   

EMERGENCY CONTACT 

  NAME:____________________________CONTACT NUMBER:__________________________    FOR OFFICE USE ONLY (Applicants do not write below this line)  APPROVED BY: _________________________________DATE: _______________________  MONTHLY FEES: ___________________NUMBER OF CHILDREN ATTENDING: _____________ 

 

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