Admission Form Parent / Guardian InformationParent / Guardian Name(Required) Relationship(Required) Home Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email Address(Required) Home Phone(Required)Emergency Phone(Required)Cell Phone(Required)HiddenProgram Information Full Time Hifz Program Part Time Hifz Program Weekend Program (Ladies/Girls) Saturday Program (Adults/Boys) Aalim/Aalima Course (Urdu) Aalim/Aalima Course (English) Nazirah Part-Time (Mon – Fri) 2 Year – Arabic & Islamic Studies (New) I Year Arabic Intensive Summer Program (Kids) Summer Program (4 Week Deen Essentials)) Summer Hifz Program Mini Mu’mins Program Others Location Devon Campus Skokie Campus Student information(Required)Student NameDate Of BirthGenderProgram Full Time Hifz ProgramPart Time Hifz ProgramWeekend Program (Ladies/Girls)Saturday Program (Adults/Boys)Aalim/Aalima Course (Urdu)Aalim/Aalima Course (English)Nazirah Part-Time (Mon – Fri)2 Year – Arabic & Islamic StudiesOthers Add RemovePayment Pay Online Pay at Office Pay by Zelle: zelle@suffaheducational.org CommentsThis field is for validation purposes and should be left unchanged.