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Muslim Cheldren Education & Civic Center

MCECC Sunday School 2010

 

Excellent opportunities to introduce your children to Islamic education and ability to read and under stand the Quran.

 

Registration Form

 

Student/s Information

 

Name 1: ………………….…   ……………….…..     …………..……………….........................................                                

                      First                                            Middle                                           Last                         Date of birth                 Sex             Age

 

Name 2: ………………….…   ……………….…..     …………..……………….........................................                                

                      First                                            Middle                                           Last                         Date of birth                 Sex             Age

 

Name 3: ………………….…   ……………….…..     …………..……………….........................................                                

                      First                                            Middle                                           Last                         Date of birth                 Sex            Age

 

Name 4: ………………….…   ……………….…..     …………..……………….........................................                                

                      First                                            Middle                                           Last                         Date of birth                 Sex             Age

 

Parent’s Information

 

Father’s Name: …………………     …………. . .……      ………………………       …………………..

                                                           First                                           Middle                                 Last                  Cell phone                                      Email

 


Mather’s Name: …………………     …………. . .……      ………………………       …………………..

                                                           First                                           Middle                                 Last                  Cell phone                                      Email

 

Student lives with:

Father & Mother               Father                 Mother                     Step-Father                   Step-Mother                     Other

 

Home Address:


……………………….……………………………………….………………Cell Phone #   (             )            

        Street                                                       City                                   State                            Zip                        
               Home Phone # (              )         -                             Work Phone #  (                )   

 Tuition Fee:  ( $65:00 for 1st child, $75.00 for Two (2) children, $85.00 for Three (3) children, and additional child  is free)

Registration & Books fee:  There will be $30.00 one time fee for registration & welcome folder.

 

I like to pay tuition fee every month            every semester (three month)          annually     

I have financial difficulties, so I like to apply for tuition reduction 25%           50%            75%       

I certify that all information provided above is true to the best of my knowledge.

 

 

Parent’s name: ___________________________ Signature _____________________            Date: ____________

 


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