Juniors Online Hifdh
$150
$100
/ month
Parents Name
Parent's Phone Number
Parents Name (2)
Parent' Phone Number (2)
Email address
Address
City
State
Postal Code
Student Name
Student Gender
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Male
Female
Age
Grade
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Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
Does your child have any disabilities, learning needs, behavioral challenges, or anything else you'd like us to be aware of to better support them?
Does your child have any allergies (food, medication, environmental, etc.) that we should be aware of?
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No
Yes
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Juniors Online Hifdh • Miftaah Institute
