Fall 2019 Arabic Grammar Class: Session III

Registration Form

• Thursdays: 7-8:30: Sept. 12- Nov. 8

• Middle School, High School and Adults Welcome

• Teacher: Nur Kose: UNC Senior English Major & Arabic Minor

• $25 Registration: All proceeds will go to ZF Programs(Email nayma@zakat.org if fee

waiver needed)

• Location: ZFNC Community Center 5410 NC Highway 55 Suite AC Durham

• To register, return the completed form to nayma@zakat.org by Sept. 8, 2019

• Must be able to read Quran frequently; If student did not participate in Session I and II, need to
email nur.misskose@gmail.com for permission & testing.

Student’s Name:

Middle _____ High _____ Adult _____

Email:________________________ Phone: _________________________

Father/Guardian Information (If middle/High School):

Father or Mother Name:

Father’s/Mother’s Contact Number: __________________

Emergency/Medical Information:

If neither parent or guardian can be reached in case of an emergency, call: __________________

Does your child have any special needs, allergies, or behaviors we need to be aware of?

________________________________________________________________________________________________________
Zakat Foundation of America | P.O. Box 639, Worth, IL 60482 5410 NC Highway 55 Suite AC Durham, NC
p: 315-383-2211 | toll free: 1.888.925.2887| www.zakat.org | nayma@zakat.org | Tax ID 36-4476244
Class Rules

• Bring notebook & pencils

• Food is not allowed during class hours.

• Students must be on time each class period.

• Foul language and disrespect to instructors will not be tolerated.

• Parents need to be at center 10 min before class is over. Late fee: $5 for every 10minutes

• Pictures may be taken in publications by Zakat Foundation of America.

• Unexcused absences will mean that student is not registered in the program anymore.

• I/We will not hold Zakat Foundation of America, ZF staff, or ZF volunteers responsible for

any accidents that may occur.

• I/We certify that all of the information given on this form is correct and accurate to our

best knowledge. I/We promise that I/we will notify ZF, if any or all of the information

changes.

Mother’s/Father’s Signature Date

________________________________________________________________________________________________________
Zakat Foundation of America | P.O. Box 639, Worth, IL 60482 | 5410 NC Highway 55 Suite AC Durham, NC
p: 315-383-2211 | toll free: 1.888.925.2887| www.zakat.org | nayma@zakat.org | Tax ID 36-4476244