Online Class - Junior Al-Hafiz (promo) — iLuvQuran

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Online Class - Junior Al-Hafiz (promo)

Student's Information
Student's Name*
Student's Age*
Student's IC/Date of birth*
Student's School*
Parent's Information
Mother's Name*
Mother's Phone Number*
Mother's Email*
Occupation
Father's Name*
Father's Phone Number*
Father's Email*
Occupation
Home Address*
Select Primary Contact*
- Mother
- Father
For billing and invoicing purposes
Survey
Where did you find out about our class?*
If Other, please specify:
Other specific important information we should know?

e.g: medical or health info such as allergies or special need
What are your expectations from the class?
Junior al-Hafiz Online Class Monthly Fee*
Price:
additional Rm9.90 for the learning management system(monthly)
Registration and Annual Fee*
Price:
Ambassador Code or Agent ID

Please enter DT Code or Agent code here if available
Total
RM 0.00
Payment Method*
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- FPX / Online Banking / Billplz
- Credit Card
Credit Card
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