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Home
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Islam Comprehensive
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Taha
2019-02-27T14:36:48-08:00
Phone
Parent/Guardian Full Name
*
Primary contact person
Parent/Guardian Phone Number
*
Parent/Guardian Email
*
Home Address
*
Home Phone
If applicable
City, Province
*
Emergency Contact Full Name
*
Emregency Contact Phone Number 1
*
Emregency Contact Phone Number 2
*
Relation to Student(s)
*
Number of Children
One
Two
Three
Four
Five
If you are registering more than 5 children, please fill out the form a second time. Please fill out the sections below which apply (according to the number of children)
1- Child One Full Name
*
Child 1: Date of Birth
*
1- Gender
*
Male
Female
1 Health Card Number
*
1 Medical Conditions/Allergy Information
*
