New Summer Program Application

Summer Program Application

Minors (below 18 years of age) are not guaranteed eligibility to enroll in full-time or part-time programs at Darul Qasim as a standard policy.
Darul Qasim reserves the right to approve or reject an applicant's admission as a full-time or part-time student

Click here for Instructions to reduce Driver's License image to under 300K

New Students Application Form

Payment Plan

Default Payment Plan for Invoice

Personal Information

First Name

Middle Name

Last Name

Gender

Birth Date

Cell Phone

Street

Country

City

State/Province

Zip/Postcode

Ethnicity

Race

Drivers License or ID

Emergency Contact - 1*

Emergency Contact Name

Relationship

Cell Phone

Emergency Contact - 2*

Second Emergency Contact

Relationship

Cell Phone 2

Email Address 2

Program Details

How did you learn about Darul Qasim College?

What are your goals while at Darul Qasim?

Proof of High School Completion

For the following subjects, list your background studies for each.

QURAN RECITATION STUDIES

Please describe your level of proficiency and comfort when reciting the Qur’an while looking at the Mushaf text?

ARABIC STUDIES

Where did you complete your studies of these courses/texts?

To what extent were these texts covered, and across what time frame did this coverage take place?

List the names of the teachers and instructors with whom you have studied.

Please provide references and their contact if available

Please upload all your previous certificates and asanid (consolidate all as one doc/file)

DISCLOSURE AND WAIVER

Understand that:

The institution gives no warranties regarding admission.
I am applying as a student or on behalf of my child at this institution.
The institution holds the right to accept or deny applications.
The institution makes no representations or warranties regarding accreditation.
The institution makes no representations or warranties regarding future advancement.

I have read the Disclosure and Waiver and I acknowledge and accept the terms and conditions of submitting this application form and all the results thereafter by Darul Qasim and its staff