Al-Bayan School

Al-Bayan School HDM

Quran Classes Monday and Wednesday 6 pm - 7:30 pm

No.

Name:*

Sex:*

Age:*

Level*

Parent First*

Middle

Parent Last*

Telephone: (Home)

Cell Phone:*

Spouse's Telephone:

Parent Email Address

Parent Home Address:

First Name*

Middle

Last Name*

Relation

Telephone: (Home)

Cell Phone:*

Spouse's Telephone:

Emergency Contact Address

Applicant's Signature (Your name)*

Date*

Payment: Automated and applied on the first day of each month for the following months:

Sep, Oct, Nov, Dec, Jan, Feb, Apr, May, June

Monthly Fee: $30 per child

One-Time Registration Fee: $30

Requirements: Auto-payment setup required

Eligibility: Children ages 4–15

February and March are off for the following holidays:

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