STUDENT ENROLMENT FORM

Address: Shop #11, Claymore Shopping Centre, Claymore 2559

Instructions:

-> If you are an EXISTING student, please click on the Re-Enrolment button
-> If you are BRAND NEW, please click the New Enrolment button

New Enrolment

Re-Enrolment

IMPORTANT – Please READ before completing the form.

This form is only if you are an existing student. If you are brand new, please click the New Enrolment button and fill out the details in that form.
You will have option to pay NOW or pay later using eftpos or in cash. Please select the appropriate option.
Back to Basic course is not included for this form.

"*" indicates required fields

How Many Students in Your Family are You Enrolling?*

Please enter a number less than or equal to 10.

Primary Student Details:

First Name*

Surname*

Mobile Number*

Email*

Gender*

Age Group*

Student 1 Fees

Price:

Student 1 Fees

Price:

Student 2 Details:

First Name*

Surname*

Gender*

Age Group*

Student 2 Fees

Price:

Student 2 Fees

Price:

Student 3 Details:

First Name*

Surname*

Gender*

Age Group*

Student 3 Fees

Price:

Student 4 Details:

First Name*

Surname*

Gender*

Age Group*

Student 4 Fees

Price:

Student 5 Details:

First Name*

Surname*

Gender*

Age Group*

Student 5 Fees

Price:

Student 6 Details:

First Name*

Surname*

Gender*

Age Group*

Student 6 Fees

Price:

Student 7 Details:

First Name*

Surname*

Gender*

Age Group*

Student 7 Fees

Price:

Student 8 Details:

First Name*

Surname*

Gender*

Age Group*

Student 8 Fees

Price:

Student 9 Details:

First Name*

Surname*

Gender*

Age Group*

Student 9 Fees

Price:

Student 10 Details:

First Name*

Surname*

Gender*

Age Group*

Student 10 Fees

Price:

Payment

This field is hidden when viewing the form

Tell us if you already paid for Male Quran class under Sheikh Riedwan?*

Yes

Payment*

Pay Now

Pay Later

Do You Want To Pay In Person?*

Yes

Total Fees

Credit Card

Card Details

Cardholder Name

Please Note:

Children’s Quran class per term $120. Course materials buy and managed by own.
Brother and Sister Adult Quran Class per term $120 fee applies.
For Quran classes (per term) first student enrolment from family $120 full fee apply & any other family members enrolment for any Quran class will be $80 with a $40 discount. (Applies to all Quran classes -Brother, Sister & children)
Additional fees may apply to cover course materials and/or operational costs (to be agreed upon with student or student representative).
Please advise the class coordinator if you are unable to pay the fees.
Class time may be changed subject to teacher availability.

Student Responsibility:

All students throughout their study and involvement with, Al Barakah Centre, are excepted to:

Treat all people with fairness and respect.
Respect the opinions and backgrounds of others.
Notify us if any of their personal or contact details change.
Report any perceived safety risks as they become known.
Approach their lesson with due personal commitment and integrity.
Notify if any difficulties arise as part of their involvement in the program.
Make payments for their training within agreed timeframe.

Privacy Statement*

By completing this form you consent to the Al Barakha Centre colleting your personal information for the purposes of enrollment to Education Program.