Back2Basics

Back2Basics Enrolment form

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Which age group do you belong in? *

Less than 15 15-18 19-25 Over 25

Which Course date would you like to attend? *

Saturday 3rd February 2018 Saturday 3rd March 2018 Saturday 7th March 2018

Submit

Luton Central Mosque
2-12 Westbourne Road
Luton, LU4 8JD
Registered Charity No. 1129781
01582 250 986