Leeds Grand Mosque - Registration Form

Registration Form for Quranic Memorisation Course

Terms and Conditions for Applying:

The age of your child is 5-12 years

Full commitment to come and leave on the exact assigned time for the circles (Every Tuesday and Friday from 6:00-7:00pm) starting on Friday 4^th May 2007.

Your child must be committed to our Islamic Ethics and happy to follow them.

Filling this application form ( Deadline for registration will be Wednesday 2^nd May 2007).

Paying the registration fee (£15 for the first child and then £10 for the second and £5 for the next ones). You can pay the registration fees on the first day Friday 4^th May 2007.

Parents Section


First name:
Surname:
Full Address:
Postcode:
Email:
Mobile:
Telephone:

Child/Applicant Section


First name:
Surname:
Gender:	MaleFemale
Date of Birth
Mother Tongue:
Please state whether child has medical condition or disability:
Chapter/surahs of Qur'an that child has already memorised:

Contact in case of emergency (if different to parent)


First name:
Surname:
Full Address:
Postcode:
Mobile:
Telephone: