Junior Al-Hafiz Online Class Registration

Student's Information

Student's Name*

Student's Age*

Student's IC/Date of birth*

Student's School*

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*

For billing and invoicing purposes

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?

Ambassador Code or Agent ID

Please enter DT Code or Agent code here if available

Select class packages

Coupon

Registration and Annual Fee*

Price:

note: monthly fees will be invoiced later and an additional Rm9.90 for the learning management system (monthly)

Total

RM 0.00

Term and Conditions

By clicking this Term and Conditions; parents/students are confirming that they have already read, understood and agreed to all the terms and conditions for iLuvQuran Online Class and iLuvQuran is not responsible for any loss due to non-compliance with these terms and conditions.

Payment Method*

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