QSI Tajweed Course

Registration Form
Student Info:
First Name:*
Last Name:*
Middle Name:
Gender:*
Birth Date:*

Parent/Guardian Info:
Guardian Name:*
(if applicable)
Relationship
to Student:*
Phone:*
Email:*
Address:*
City:*
Province:*
Country:
Postal/Zip Code:*

Emergency Contact:
Name:
Phone Number:


Further Details
Start Date: Friday, June 10, 2016
End Date: Saturday, June 25, 2016
Days:
Friday:5:30 PM to 6:30 AM
Fees: *
Place: 4416 36 Ave NW, Edmonton, AB T6L 3S1
Other Info: