Tahfeez Al-Quran School Application

Islamic Center of Jersey City

17 Park St. Jersey City, NJ 07304

Phone: (201)-433-5000

Fax: (201)-433-5001

Child Last Name:____________________ Child First Name:_______________

Address: __________________________ City: ___________ State:____ Zip:______

Child Birth Date:_________ Phone Number:__________________

Email Address:_________________________

Parent’s Name:___________________________

How many Child attending Tahfeez Al-Quran School:______

For Center Use Only:_______________________

Islamic Center of Jersey City

17 Park St JC NJ 07304

Tel : 201-433-5000

Fax: 201-433-5001

Membership Application

First Name:__________________ Last Name:__________________________

Address:___________________________ City:___________________ State:____ Zip:_________

Home Phone:( )__________________ Cell Phone: ( )_____________________

Email:__________________________________

Membership Fee: $20

Tel : (201) 433 - 5000 Fax : (201) 433 - 5001 E mail : ICJCMasgid@hotmail.com