Hifz Application - Alhussnain

Student Information

Name

First Name *

MI

Last Name *

Date of Birth *

Address

Address *

City *

State *

zipcode *

Country of Citizenship *

Country of Birth *

Please Select a field of Admission *

Nazra
Part Time Hifz
Full Time Hifz

Parent/Guardian Information

Name

Parent Name *

Parent Relationship to student *

Parent Phone *

Parent Email *

Parent Occupation

Emergency Contacts

Emergency Contact1 Name *

Emergency Contact1 Relationship *

Emergency Contact1 Phone *

Emergency Contact1 Email *

Tuition payment method *

Cash
Check
Zelle
Direct Deposit

Please select appropriate field *

Nazra $50
Part Time Hifz $75
Part Time Hifz (sun) $100
Full Time Hifz $150

Send Tuition via Zelle to info@alhussnain.org

Fill and Send ACH form to info@alhussnain.org or mail it to 5047 Deer Creek Pl, Indianapolis IN 46254

Mail your check to: 5047 Deer Creek Pl Indianapolis IN 46254

Provide following information about your child

Government ID *

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I certify that this information is complete and accurate. I understand that making false statements within this application may result in denial of admission.

If admitted, I agree to abide by the policies set forth by the Institution and all of its rules and regulations.

Consent checkbbox *

I Agree

Parent Signature *

Date *

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Apply

Thank you for your interest in our Seminary

Student Information

Parent/Guardian Information