Enrollment | Halpoular Of Iowa

Enrollment Form

Submit this form to register your child(ren) for our programs. We will follow up by email with location, schedule, and next steps.

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Parent/Guardian Full Name

Phone Number

Email Address

City

Preferred program(s)
Select all that apply.
After-School Tutoring Weekend Islamic Studies Fulani Language & Culture

Child #1 Full Name

Child #1 Age

Child #1 Grade

Child #2 Full Name (optional)

Child #2 Age (optional)

Child #2 Grade (optional)

Availability

Learning needs (optional)

Allergies / medical notes (optional)

Emergency contact name

Emergency contact phone

Photo permission

Anything else we should know? (optional)

Back to Contact

If you have trouble submitting, email us at Halpoularofiowa2013@gmail.com.

Admin note: On Netlify, enable email notifications under Site settings → Forms → Form notifications.