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Islamic Center of Staten Island

365 VETERANS RD W, Staten Island, New York 10309, USA

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Program Information

Beginner Adult Arabic Class

Program Start Date: 06/04/2023 Program End Date: 08/27/2023

View Details $100.00

1 Contact Information

First Name *

Last Name *

Phone Number *

Email Address *

Address1 *

Address2

Country *

State *

City *

Zip Code *

Cell Number

2 Add Registrants

Primary Contact as First Registrant

Registrant Name*

Email Address

Age

Gender

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3 Payment

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 Islamic Center of Staten Island consent to authorize electronic fund transfer from the account specified for this transaction in the amount specified.

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Islamic Center of Staten Island

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Program Information

Beginner Adult Arabic Class

1 Contact Information

2 Add Registrants

3 Payment

Payment Summary

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