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 *
What program do you want to enroll in ?
STUDENTS FULL NAME *
Street Address and Apt#(if any) *
City *
State *
Zip *
Phone Number (Home)
Phone Number (Cell) *
Birth Date

Students Gender *
US Citizen *
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:
  1. All the information I have provided in the Darul Uloom Chicago(DUC) Registration form is true and correct to the best of my knowledge.
  2. I agree to pay the monthly payment by 5th of the month until the amount is paid in full.
  3. 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.
  4. 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.
  5. 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.
  6. I understand my child will be taken on field trips with my written consent.
  7. I understand that the school will take any necessary action during an emergency situation.
  8. I indemnify DUC from any legal liability whatsoever.