Apply online – IQRA Learning Centre

ONLINE FORM

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What is your full name? *

What is your full address? *

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What is your email address? *

What is your mobile number? *

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What is his full name? *

What is his full address? *

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What is his email address? *

What is his mobile number? *

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Have you applied for a civil divorce? *

What date did you get married? *

Do you have a civil divorce already? *

For what reasons are you applying for an Islamic Divorce: (please select)

Physical abuse
Psychological abuse
Emotional abuse
Financial abuse
Absent husband: absconded or missing
Failure to provide maintenance: inability or refusal
He has given the Talaq
Lengthy imprisonment
Serious health condition or disease: insanity, leprosy, impotency, HIV or any such disease that could endanger the wife
Other(s)

Other(s)

Please detail what evidence you have to support your case? *

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Please attach a copy of your passport or driving licence?

Click or drag a file to this area to upload.