Request Enrollment

Share the prospective student's details, preferred weekly session count, and available live-session hours. The Quraan Academy team will review placement and confirm the best class options.

Student Information

Parent / guardian (required only when the student is under 18)

Parent/guardian name

Relationship to student

Describe relationship

Parent/guardian email or phone

Parent/guardian phone / WhatsApp

Emergency contact name

Emergency contact phone

Student

First name

Middle name

Last name

Display name

Student access type

Student email or phone

Age

Gender

Special Needs

Placement

Course

Country

City

City not listed

Primary language

Preferred teaching language

Other languages

Placement level

Tajweed sub-level

Learning background

Preferred weekly live-session number of sessions and hours

Number of sessions

Time zone

Select all recurring times that could work

Day	8:00 AM	9:00 AM	10:00 AM	11:00 AM	12:00 PM	1:00 PM	2:00 PM	3:00 PM	4:00 PM	5:00 PM	6:00 PM	7:00 PM	8:00 PM	9:00 PM	10:00 PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Notes and consent

Parent preferences

Send parent email notifications when the parent contact is a valid email address. Student or parent/guardian consents to live interactive classes. Student or parent/guardian consents to class recording when recording policy allows.

Consent notes/comment

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