Mississauga Muslim Community Center

Student Admission

Minhaj School Of Canada Admission

* Required information

Student Information

First Name

Last Name

Phone

Address

City

Postal Code

Date Of Birth

Age

Gender

Male

Female

Applying For

Session / Class

Are You Existing Student

Currently Studying In

School

Class and Year

Parent / Guardian Information

First Parent/Guardian

Relationship

Phone

Occupation

Receive Email Notifications

Second Parent/Guardian

Relationship

Phone

Occupation

Emergency Contact Information

Emergency Contact Name

Phone

Relationship

Emergency Contact Note

Additional Information

How Did You Hear About Us

WhatsApp Phone Number

Citizen Status

Spoken Language 1

Spoken Language 2

Spoken Language 3

Transportation Required

Medical Condition Doctor info along with conditions, allergies, and special need

Qualifaction

Note

NOTE: The provided information will enhance the students' learning experience, making it more enjoyable and fulfilling, and will be treated with the utmost confidentiality.

Financial Institution

REQUEST: In order to streamline our fee collection process, we kindly request your cooperation in providing your bank account information, which will be exclusively utilized for this specific purpose.

Consent to Release Information to Bank

AUTHORIZATION: I hereby grant my consent for the processing of the bank account details I have supplied, and I affirm my agreement with Mississauga Muslim Community Center to facilitate automatic deductions for student fees in accordance with the enrolled class's frequency and duration.

Bank Code or Name

Bank Branch, Transit or Routing Number

Bank Account Number

Attach Void Cheque To validate the bank information, please take a picture of your void cheque and upload here or email us at info@mmcc-canada.org

Declaration I confirm that the information given in this application form is correct. I have read the school rules and regulations and I take responsibility that my child will abide by them, will arrive on time, and will be punctual in attending the school. Any absence will be authorized beforehand in written format. I ensure that I will assist my child in maintaining his/her level of study.

Waiver I, hereby waive my right to make any claim against Management and Volunteers of Mississauga Muslim Community Center, in case of any harm/injury to my child or loss of any valuable / belongings during attendance in class. I will assume full responsibility of compensation to Mississauga Muslim Community Center for any damages to the property caused by my child. In the case of an emergency, I give permission to transport my child to a hospital for medical treatment.

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