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First Name

Last Name

Date of Birth

Phone

Address

City

State

Zip Code

Schools Attended

Degrees earned

Please describe your level of Islamic knowledge.

What Islamic studies have you pursued?

Have you participated in any religious activities or organizations? If so, please specify.

What roles have you held in these activities (e.g., teacher, volunteer, leader)?

Why are you interested in joining the Hawza program?

What are your goals after completing the program?

Level of proficiency in Arabic

Level of proficiency in English

Payment Method

Which installment option you’d like to pick?