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Student's First Name(*)
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Last Name(*)
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Email Address(*)
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Address
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City(*)
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State(*)
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Country
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Time Zone(*)
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Phone Number(*)
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Phone 2
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Age(*)
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Your Gender(*)
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Which Course do you want to enroll in?(*)
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Arabic Course
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Arabic Tuition Subscription Plan
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4 hrs/month ($45) 6 hrs/month ($69) 8 hrs/month ($85) 10 hrs/month ($99) 15 hrs/month ($149) 20 hrs/month ($198)

Qu'ran Course
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Qur'an Tuition Subscription Plan
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4 hrs/month ($45) 6 hrs/month ($69) 8 hrs/month ($85) 10 hrs/month ($99) 15 hrs/month ($149) 20 hrs/month ($198)

Preferred Days/Times(*)
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Can you read Arabic?(*)
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What is your level of Arabic?
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Which gender of teacher do you prefer?(*)
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How did you hear about Studio Arabiya?(*)
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Please specify
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Do you have a promotion code?
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Special Requests
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