Select Course*
—Please choose an option—Hifz + Secondary (Std 10th)Deeniyat + Secondary (Std 10th)

Preferred Class*
—Please choose an option—5th6th7th

Student Full Name*

Date of Birth*

City / Village*

District*

Previous Year Grade*
—Please choose an option—A+ (90% to 100%)A (75% to 89%)B (56% to 74%)C (35% to 55%)D (Below 35%)

Guardian Full Name*

Guardian Relation*
—Please choose an option—FatherMotherSiblingsOther

Guardian Occupation*
—Please choose an option—BusinessJobHome MakerSelf Employed

Email Id*

Guardian Contact No.*

Secondary Contact No.