Student Registration Form
Personal Information
1. Full Name: _______________
2. Father/Guardian's Name: _______________
3. Student’s Age: _______________
4. Gender: ☐ Male ☐ Female
5. Nationality: _______________
6. Address: _______________
7. City & Country: _______________
8. Contact Number (WhatsApp): _______________
9. Email Address: _______________
10. Father/Mother/Guardian’s Name: _______________
11. Guardian’s Contact Number: _______________
12. Parent's Occupation (Optional): _______________
13. Have you studied the Quran before? ☐ Yes ☐ No
14. What is your current level?
☐ Beginner – Noorani Qaida
☐ Nazra Quran (Reading Only)
☐ Hifz (Memorization)
☐ Tajweed & Qira’at
☐ Other (Specify): _______________
15. Preferred Language for Classes:
☐ Urdu
☐ English
☐ Arabic
☐ Other (Specify): _______________
Learning Preferences
16. Preferred Class Timing (Mention Time Zone): _______________
17. Class Type:
☐ One-on-One
☐ Group Class
18. Preferred Days for Classes:
☐ Monday ☐ Tuesday ☐ Wednesday
☐ Thursday ☐ Friday ☐ Saturday ☐ Sunday
19. Number of Classes Per Week:
☐ 3 Days ☐ 5 Days ☐ 6 Days
Technical Requirements
1. Do you have a stable internet connection? ☐ Yes ☐ No
2. Which device will you use for classes?
☐ Mobile Phone
☐ Tablet
☐ Laptop/Computer
3. Do you have experience using online class software like Zoom/Skype? ☐ Yes ☐ No
Payment & Fees
1. Would you like to apply for a scholarship/discount? ☐ Yes ☐ No
2. Preferred Payment Method:
☐ Bank Transfer
☐ PayPal
☐ Western Union
☐ Other (Specify): _______________
Additional Information
1. What is your goal in learning the Quran?
☐ Learn Basic Quran
☐ Complete Memorization
☐ Improve Tajweed & Recitation
☐ Understand Islamic Teachings
2. Any specific requests or comments? _______________
Declaration
I confirm that all the information provided is accurate and complete to the best of my knowledge. I agree to follow the academy’s rules and regulations.
Student’s Signature: _______________
Guardian’s Signature: _______________
Date: _______________
