Monthly Weekend Request Form

Parents are requested to fill this form so that we can give raza to our students for their monthly weekend. Students can be picked up from Fakhri Makan or Nuzul al Barakah on Saturday after 2:00 PM and must be dropped back on Sunday by 8 P.M. Students should not be arriving later than 8 PM.

STUDENTS ARE NOT ALLOWED TO LEAVE FAKHRI MAKAN / NUZUL DURING THE WEEKEND UNLESS PICKED UP/DROPPED OFF BY AN ADULT WHO IS AUTHORIZED BY THEIR PARENTS IN THIS FORM. STUDENTS LEAVING FAKHRI MAKAN / NUZUL WITHOUT PERMISSION WILL NOT BE ALLOWED TO RETURN TO FAKHRI MAKAN / NUZUL.

You do not need a raza slip if this form has been filled out.

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Student Name *

First

Middle

Last

Please provide the full name, e.g. Adnan Shk Shabbir bhai Hussain

Parent/Guardian Name *

First

Last

Parent/Guardian Contact *

Date Time Parent/Guardian

Parent/Guardian Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Please provide the address at which the student will be staying during the weekend.

Departure Date and Time *

Date

Time

Must be after Saturday 2:00 PM

Arrival Date and Time *

Date

Time

Must be before Sunday 8:00 PM

Submit