IQRA ISLAMIC SCHOOL

Student Information:

Date of Birth (mm/dd/yy):

Session: 2020-21

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: