Name:
Address:

Phone:		Email:

Please check:	I am a new-Muslim. I took the shahada on:
	I am not a Muslim but would like to learn about Islam

When would you like to start:
Comment or expectation from the course:

There is no fee for the course. However, the following is expected that the student:

bring notebook, pencil, and a three-hole binder to the class to organize handouts
come to the class a few minutes early so that the class can always start on-time and no time is wasted
inform the instructor by phone/email if he/she cannot come at a certain day



Signature	Date

After you submit the registration form, you will be contacted within a few days about the status of the registration and when you can join the class. However, before you submit, please print this form using the "Print" button in your browser, sign it, and give this to the instructor at the first day of the class.