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The Islamic Cultural Institute

30115 Greater Mack Ave, St Clair Shores, Michigan 48082, USA

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Iman School 2022/2023

17
SEP

3:00 PM

20
MAY

6:00 PM

Program Fee:

One Time: $400.00

Offering Days: Saturday

View Details

1 Parent Contact Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

State *

City *

Zip Code *

Cell Number

2 Add Students

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

Gender

Choose Program

Age*

List All Allergies

List Any Important Information About Your Child

+ Add More Registrants

3 Payment

You can help save us on credit card transaction fees by selecting the eCheck/ACH option. Jazak'Allah!

Payment Method

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Credit/Debit Card

Name on Credit Card *

Credit Card Number*

Expiry Date*

CVV Code*

Bank Name

Name on Account *

Account Number*

Routing Number*

Account Type*

Monthly Recurring

Recurring Start Date*

Number of Months*

For Lifetime

Please note: You will incur a $1 charge if the recurring start date is not current date in order to verify the payment details provided. This charge will not be credited back to your account and you will receive a test transaction receipt for this amount.

Consent * Do you give The Islamic Cultural Institute consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Payment Summary

Program Fee

Total Registrants

Total Cost

Acknowledgement

By registering , you acknowledge that you will follow all the instructions provided to you by the Masjid for your and other community member's safety

The Islamic Cultural Institute

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Iman School 2022/2023

1 Parent Contact Information

2 Add Students

3 Payment

Payment Summary

Acknowledgement

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