Quran Programs | Masjid Bilal

Parent / Guardian Information

Parent / Guardian's Name *

First

Last

Phone *

Email *

Email

Confirm Email

Please provide a valid email address, as we will use this to provide payment information, updates on class cancellations, and any other important updates.

Would you be interested in teaching and/or offering your time to help support this program? (both Volunteer and Paid positions are available) *

Yes, Masjid Bilal may contact me to discuss any open opportunities.
No, I am not available at this time.

Student Information

Student's Name *

Students' Birthdate *

Gender *

Male
Female

Session *

Monday - Wednesday Evening
Sunday Morning

Confirmation Statement *

I confirm that the above information is accurate and correct.

Quranic Program

Parent / Guardian Information

Student Information