Student Inquiry Form

Student’s Full Name:

Date of Birth:

Gender:

Grade Applying For (K–12):

Current School (if applicable):

Parent/Guardian Name:

Relationship to Student:

Email Address:

Phone Number:

Alternate Phone (optional):

Home Address:

City:

State:

ZIP:

Has your child previously attended an Islamic school?

How did you hear about Houston Quran Academy?

Which one?

What interests you most about our school?

I certify that the above information is true and complete to the best of my knowledge.

Date:

Parent/Guardian Signature:

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