IQRA ISLAMIC SCHOOL

Student Information:

Date of Birth (mm/dd/yy):

Session:2020-212021-222022-232023-242024-252025-262026-272027-282028-292029-30

Place:

Gender:MaleFemale

Canadian /Landed Immigrant?CanadianLanded Immigrant

Immigration Authorization Expiry Date (mm/dd/yy):

Name & grade of any brother/s or sister/s attending (or will attend) IQRA Islamic School:

Name:

Date of Birth (mm/dd/yy):

Father's Contact information:

Mother's Contact information:

Emergency contact (Not the name of the Parent/Guardian):

General Information (If Applicable):

Medical Information: