Enrollment Form
You are applying for Houston Quran Academy
Applicant Information
First Name *
Last Name *
Gender *
Date of Birth *
Grade *
Email *
Mobile No. *
Any identified need/disability? *
Blood Group *
Liability Form
Facilities Document Preview
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Handbook
Handbook Document Preview
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Parents & Other Details
Mother's Name *
Father's Name *
Mother's Contact *
Father's Contact *
Primary Phone *
Secondary Phone *
Parent Email *
Marital Status *
Mother's Occupation *
Father's Occupation *
Street Address *
City *
State *
Postal/ZIP Code *
Country *
Ask your queries *
Guardian’s Details
Full Name *
Relationship to Student *
Contact Number *
Address *
Medical Information
Primary Doctor’s Name *
Primary Doctor’s Contact Number *
Street Address *
City *
State *
Postal/ZIP Code *
Country *
Allergies (if any) *
Existing Medical Conditions *
Special Needs (if any) *
Primary Emergency Contact
Name *
Contact Number *
Relationship *
Secondary Emergency Contact
Name *
Contact Number *
Relationship *
Documents Upload

(Documents should be in PDF/JPEG format)

Birth Certificate *
Immunization Record *
Previous School Transcript *
Parent/Guardian ID *
Proof of Address *
Declaration
  • I hereby declare that the information given above is true and correct to the best of my knowledge.
  • I understand that any false information may result in cancellation of admission.
  • I have received and reviewed HQA handbook.
  • I have received and reviewed liability document.
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