MJUM School Registration

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Welcome to Jamaat-ul-Muttaqeen Student Registration System.

Please fill in your children's information as well as yours below.

Student Information

Student First Name*

Student Last Name*

Student Email Address*

Student Date of Birth*

Student Home Phone*

Student Gender*

Student Street Address

Student City

Student State

Student Zip Code

Parent Information

Parent First Name*

Parent Last Name*

Parent Email Address*

Parent Home Phone*

Parent Work Phone

Parent Cell Phone

Parent Gender*

Parent Street Address*

Parent City*

Parent State*

Parent Zip Code*

Special Accomodations

Please provide a detailed description of any special needs of your child. Does your child suffer from allergies or have any medical issues?

Accommodations Details (5000 chars left)

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Join MJUM Mailing List*

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