School Registration Form — MASJIDULLAH

SISTER CLARA MOHAMMED SCHOOL

REGISTRATION FORM

PRIMARY PARENT INFORMATION

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Email

Additional Email

Mobile Phone Number

(###)

###

####

Home Phone Number

(###)

###

####

Emergency Phone Number

(###)

###

####

STUDENT INFORMATION

For each student, please add: name, age, gender, date of birth and grade level.

Additional Comments