Quran Classes Application Form

Children's Qur'an Classes

Monday and Wednesday 4.30pm to 5.30pm, for 12 weeks. With Imam Mucteba Torlak...

Applicant's Informations

Applicant's Info

Student's Full Name *

Cinsiyet: * Bay Bayan

Date of Birth *

Place of Birth *

Father's Name *

Mother's Name *

Next of Kin

Address *

Mobile *

E-posta *

Occupation *

If Student - Name of School

* I understood that this application form is just for 1 term (12 weeks)

$ Donation Amount:

You can choose a custom amount but it should be higher than the minimum amount (min. $100)

Your Personal Informations

We’ll never share this information with anyone.

Personal Info

First Name *

Last Name

E-posta Adresi *

Comment

Select Payment Method

Credit Card Info

This is a secure SSL encrypted payment.

Card Number *

CVC *

Cardholder Name *

Expiration *

Here's what you're about to pay for 1 term (12 weeks):

Donation Total: $100

{amount} donation plus {fee_amount} to help cover fees.