Shah Jahan Madrasa Registration

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Please fill the details to add your child(ren) to our waiting list. For more information, please contact us about this form.
* denotes required field
Autofill: Father Mother Brother Sister

Students

 Child #1:
 Surname:
D.O.B:
Gender:
 Email:
Enroll:
Our Weekday Madrasa runs Mon/Wed/Fri 4.45pm to 6.45pm
Add medical info/notes

Contacts

You are the primary contact. You can add more contacts below.
Additional Contact #1
 Contact Name:
 Email:
 Tel.:
 Mobile:
 Alt. Mob.:
Relation:
Type: