Evening Qur'an School - Re-Registrations

Student First Name *

Student Last Name *

Will the student be returning for school year 2022-2023? (Please Note All levels except 6 Boys are FULL and you will be put on a WAITLIST) *

Yes

You have 1 options left.

Parent/Guardian 1 First Name *

Parent/Guardian 1 Last Name *

Parent/Guardian 1 Email Address *

Parent/Guardian 1 Phone Number *

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email Address

Parent/Guardian 2 Phone Number

Emergency Contact Name *

Emergency Contact Number *

Has your address changed in the past 12 months? *

Yes

You have 1 options left.

What is your new address? *

Is there any other information you would like to update the school about? (E.g. any medical conditions) If none, please write "NONE" *

Payment Option *

E-Transfer

Cheque

Debit - (Pay in office)

You have 1 options left.

E-Transfer

Please send the total amount ($30.00/student) to [email protected]
In notes write: Student Name and EQS

Cheque

Please write the cheque to PICKERING ISLAMIC CENTRE for the total amount ($30/student).
Memo: Student Name, EQS

Cheques can be dropped off during office hours.

Debit

Please visit the office to pay in-person. Have your registration email available to show if asked.