al-husna certificate in traditional islamic...
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As-Siddiq Centre for Islamic Studies Pte Ltd 152 Still Road Singapore 423991 | Tel: 65474407 | Fax: 63486023
Email: [email protected] | http://alhusna.simplyislam.sg | Business Reg: 20060 786 1W
Registration Form SECTION A: APPLICANT’S PERSONAL PARTICULARS Photograph
Name
Identity No NRIC, FIN Date of Birth
Age Gender M / F
Address
Postal Code
Telephone (Mobile) Telephone (Res)
Race Indian / Malay / Chinese / Others Marital Status Married / Single / Divorced
Occupation Industry
Name of Company or School Organisation
Highest Academic Qualification
SECTION B: DECLARATION BY APPLICANT
I, the abovementioned, declare that all the information given is correct and agree to abide to all the rules and regulations of the Al-Husna Certificate in Traditional Islamic Studies course, jointly offered by Ihsan Institute for Arabic & Islamic Studies (UK) and As-Siddiq Centre for Islamic Studies Pte Ltd (Singapore). Date Applicant Signature Applicants below the age of 18 require parental consent.
Parent Name
NRIC No. Contact Number
I hereby give my parental consent for my child to attend the above course. Date Parent Signature
For Office Use Payment Amt Received
Receipt No Full Payment YES / NO
Remarks
Al-Husna Certificate in Traditional Islamic Studies