94 Walton Rd, East Molesey, Surrey, KT8 0DL, United Kingdom    

السَّلَامُ عَلَيْكُمْ وَرَحْمَةُ ٱللَّهِ وَبَرَكاتُهُ - Welcome to Molesey Islamic Cultural Centre and Masjid

Student Enrolment Form

Child 1 Name *
First Name
Last Name
Date
Child 2 Name *
First Name
Last Name
Date
Child 3 Name *
First Name
Last Name
Date
Child 4 Name *
First Name
Last Name
Date
Child 5 Name *
First Name
Last Name
Date
How Many classes per month with your Child/Children will be attending? *
Classes per week No of classes each Children attending?
1 = 4 classes per month
2 = 8 classes per month
Which days of the week your Child/Children will be attending? *
Which days your children will be attending? Saturday Sunday
Select days
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Please enter a valid phone number (starts with 07 and 11 digits).
Please enter a valid phone number (starts with 07 and 11 digits).
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