QSI Day School Registration Form
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Start Date:Tuesday, September 5, 2017
End Date:Thursday, May 10, 2018
Days:
Monday:9:00 AM to 3:00 PM
Tuesday:9:00 AM to 3:00 PM
Wednesday:9:00 AM to 3:00 PM
Thursday:9:00 AM to 3:00 PM
Fees:200 CAD + GST Monthly
Place:4723 91 Ave NW, Edmonton, AB T6B 2M7
Other Info:Limited Seats Available (13 Seats)

Transportation is Available at extra charge.

    Cost     Area           Pickup Point
1.  $100    Millwoods    Markazul Islam Masjid
2.  $125    North        Quba Masjid
3.  $150    West         MAC Rahma Mosque

Post dated Checks until December 2017 for Fees
and Transportation (seperately) are required
to be submitted at the time of Registration.
   
Student Info:
First Name:*
Last Name:*
Middle Name:
Gender:*
Birth Date:*
Guardian Name:*
(if applicable)
Relationship to Student:*
Home Phone: *
Mobile:
Email:*
Address:*
City:*
Province:*
Country:
Postal Code:*
Emergency Contact:  
Name:
Phone Number:

Please Contact Br. Mahmood Khan at 438-879-8441