Asalaam o Alaikum Dear Parent/Guardian!

Thank you for your interest in enrolling your child(ren) at Zaytech Academy After School Quran Class. This Program is offered 2 days a week on Monday and Wednesday from 5pm-615pm. Shaykh Ridwan Malek will be the instructor. Space is limited as we only allow 12 students per class. First day of class will be on

Wednesday September 4th 2024

. The cost to attend this class is $99.00 per month.

IMPORTANT: ONLY SUBMIT ONE APPLICATION PER CHILD

JazakAllah Khair,

Zaytech Academy Admissions Team
admissions@zaytech.com

**NOTE: Any fees paid during the application process does not guarantee your child's acceptance to the school. If your child is not accepted to the school for any reason, your fees will be refunded.

Application Details

Primary Home/Residential Address*

Street Address, City, State Zip Code

Student Information

Student Name*

First, Middle, and Last Name

Gender*

Female

Male

Date of Birth*

Month/Day/Year

Current Age*

What school does your child currently attend?*

Parent(s)/Guardian(s) Information

Primary Parent/Guardian Details

Primary Parent/Guardian First Name*

Primary Parent/Guardian Last Name*

Primary Parent/Guardian Email Address*

Primary Parent/Guardian Phone #*

Primary Parent/Guardian Relationship to Child*

Secondary Parent/Guardian Details

Secondary Parent/Guardian First Name*

Secondary Parent/Guardian Last Name*

Secondary Parent/Guardian Email Address*

Secondary Parent/Guardian Phone #*

Secondary Parent/Guardian Relationship to Child*

Any data collected is solely for the purpose of Zaytech Academy admissions, and will not be shared with anyone outside of the Zaytech Academy admissions team.