Tuition Assistance Request – Appeal Form

Darul Qasim understands and respects that the information you are submitting on this form is confidential and solely for the purpose of potentially receiving assistance for tuition payments.

In consideration of the individual disclosing confidential information on this form Darul Qasim commits to:

  1. not communicate, disclose or make available all or any part of the Confidential Information to any third party
  2. not directly or indirectly use, or permit others to use, the Confidential Information other than for the Purpose other than what the intent of the form is

This form is secure and encrypted for your protection and safety.


Tuition Assistance Appeal

  • Date Format: MM slash DD slash YYYY