Darul Uloom Chicago
Student Registration Form
A division of Rahmat-e-Alam Foundation. A Non-Profit Organization. State of Illinois Registered. IRS 501(c)(3)
7045 N Western Ave, Chicago, IL 60645. Phone : (773)764-8274 Ext 2. Fax: 773-764-4990
Type of Program *
Please choose
Weekdays
Weekend
What program do you want to enroll in ?
Nazirah & Tajwid
Hifzul-Quran
Basic Alim
Alim
STUDENTS FULL NAME *
Street Address and Apt#(if any) *
City *
State *
Zip *
Phone Number (Home)
Phone Number (Cell) *
Birth Date
Students Gender *
Please choose
Male
Female
US Citizen *
Please choose
Yes
No
Previous Islamic Education
Parent or Legal Guardian's Name *
Street Address and Apt#(if any)
City
State
Zip
Email *
Phone Number (Home)
Phone Number (Cell) *
Additional Comments
Parent/ Guardian Agreement:
By submitting the form you agree to abide by the following conditions for admission:
All the information I have provided in the Darul Uloom Chicago(DUC) Registration form is true and correct to the best of my knowledge.
I agree to pay the monthly payment by 5th of the month until the amount is paid in full.
I will be responsible for any damage caused to DUC property by my child, and will compensate or replace the damage with or equal value and quality.
I agree to follow and respect the DUC rules and regulations and explain them to my child who attends the Darul Uloom. I understand that I am responsible for disciplining my child in case of violation of any DUC rules, in conduct and/or academics. I understand that if any problem occurs, I will completely and fully accept the decision of DUC Administration.
I give DUC Administration the authority to take necessary decisions to ensure my child safety and well being when in their care. I give my child permission to participate in all activities deemed appropriate by DUC.
I understand my child will be taken on field trips with my written consent.
I understand that the school will take any necessary action during an emergency situation.
I indemnify DUC from any legal liability whatsoever.
Submit Registration
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