QSI Online Weekend School Registration Form
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Start Date:Tuesday, September 8, 2015
End Date:Saturday, April 1, 2017
Days:
Sunday:7:00 AM to 11:30 AM
Saturday:7:00 AM to 11:30 AM
Teacher: Shaikh Abu Mariam
Certified Quran Teacher
Fees:50 CAD Monthly
Place:On Line
Other Info:Our School Time Zone is 
(Mountain Time - US & Canada)

20 minute Time Slot with 
the teacher (One On One)  
each Saturday and Sunday.
   
Student Info:
First Name:*
Last Name:*
Middle Name:
Gender:*
Birth Date:*
Registering For:*
Guardian Name:*
(if applicable)
Relationship to Student:*
Home Phone: *
Mobile:
Email:*
Address:*
City:*
Province:*
Country:
Postal Code:*
Emergency Contact:  
Name:
Phone Number: