IQRA ACADEMY


Weekend School

Student's Name:
Address:

City:
State:
Parents Name:

Home Phone:

Cell Phone:

Emergency Contact:

E-Mail:

Grade in School:


Registration fee: $10.00 per month per child

Iqra Academy Hours: 11:00 am - 1:30 pm each

Please select if you are willing to help with the following:
Teaching
Help give ride to a student
Donation