Islamic Association of Arabi, Inc
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STUDENT ENROLLMENT FORM (Please print) Date:______
PLEASE FILL OUT COMPLETE FORM BEFORE REGISTERING CHILD
I. STUDENT(S) INFORMATION
1)Student’s Name______
Last First Middle
Student’s Preferred Name______Student’s Age ______
Date of Birth______Male______Female______
2)Student’s Name______
Last First Middle
Student’s Preferred Name______Student’s Age ______
Date of Birth______Male______Female______
3)Student’s Name______
Last First Middle
Student’s Preferred Name______Student’s Age ______
Date of Birth______Male______Female______
II. PARENT/ GUARDIAN INFORMATION
-Father’s (or Guardian’s) Name______
Last First Middle
Address______
E-mail:______Home:______
Cell:______Office:______
Employer:______Occupation:______
-Mother’s Name______
Last First Middle
E-mail:______Cell:______
Student lives with______
Preferred Telephone (circle one) Home Cell
SIBLINGS LIVING AT HOME:
NAME AGE
______
______
III. STUDENT INFORMATION
Does this student have physical, mental or emotional problems which require special medication? ______
If yes, please give a brief explanation.______
Any allergies to food or medication: ______
For information only: name of the child's physician ______
Telephone number of physician office______
Emergency Contacts
1.______
2.______
IV.TERMS AND CONDITIONS
a. Applications are made to the governing authority of IAA which reserves the right to accept or reject any application.
b. Thealimah/hifz/evening maktab course admits students of any race, color, or national and ethnic origin to all rights, privileges, programs and activities generally accorded or made available to students of the school. IAA does not discriminate on the basis of race, color, or national and ethnic origin in administration of its educational policies.
c. Thealimah/hifz/evening maktab course policies are subject to change. Information on current policies will be made available at parent orientation meetings prior to the 2015-2016 registration and orientation in August.
d. Applicants agree to abide by all policies, rules and regulations, including provisions for dress codes and discipline.
e. All deeni education and ways of performing worship that will be taught in all above programs will be in accordance with the Hanafi school of thought.
f. Space must be available, and the enrollment request must be exercised within the priority enrollment period. Information about priority enrollment may be obtained by contacting the Deeni Education Committeedirector.
g. Thealimah/hifz/evening maktab course does not have a reasonable standard of care for students who become ill or have an emergency situation while at the Amatur Rahman Girls Academy or any other teaching location. Parents are required to sign a medical waiver form each year allowing emergency medical care to be obtained in case parents cannot be reached. Parents understand thatthe maktab is not an insurer of student health. Parent/guardian is responsible for health care, storage and administration of medications for the individual child.
h. Thealimah/hifz/evening maktab courses’ schedule of charges provides information about financial terms and obligations. It is updated annually. Students are enrolled for the entire year and the parent or guardian is responsible for theyearly tuition payment upon accepting enrollment at the beginning of each month, either in full or divided monthly via electronic fund transfer. A non-refundable $25.00 individual student application fee must be submitted with this Student Enrollment Form, or a $50 family application fee.
i. The annual tuition for the 2015-2016 year will be $4,200 for the alimah and hifz courses, and $900 for the evening maktab course.
j. Financial aid (discounted tuition) may be provided only for those who submit a financial assistance application along with supporting documents. Zakat money may be utilized to fill in the rest of the tuition for those who have been awarded the financial aid.
k. Parents are responsible for student’s secular education.
V.PARENT OR GUARDIAN AGREEMENT
I hereby certify that I have read this Student Application Form. I do agree to comply with the terms and conditions stated therein and furthermore accept the conditions and requirements of all other official policies and procedures of the alimah course, including the payment of all fees and charges, and medical release according to thepublished schedule of the alimah course.
This application cannot be processed until the application fee is paid in full and is signed by the parents or guardian of the applicant.
Parent/Guardian Signature ______Date______
Student Pledge
- Students will refrain from using inappropriate language. Obscene language, excessive grumbling and complaining will not be tolerated.
- Students will exercise courtesy and kindness when dealing with others, as well as not harass, abuse, bully, tease, threaten, torment, humiliate, or intimidate other students either physically, mentally, or emotionally.
- Students will show respect for their own bodies, by neither possessing nor using tobacco, alcohol, other controlled substances, visible tattoos, or engaging in impure conduct.
- Students will respect the authority of the faculty and staff
- Students will show respect for the school facilities by keeping hands and writing implements away from the walls, tables, floors, and windows. Unnecessary waste or damage to school property or facilities will not be tolerated.
- Students will show respect for others by not taking things that do not belong to them.
- Students will exercise honesty at all times.
- Students at all times must follow the Sunnah of Rasulullah (S.A.W).
- Students are required to be punctual with their salat.
- Students will not participate in or view inappropriate websites.
- Students will not participate in any other conduct that, in the school’s discretion, significantly impairs the student’s testimony or brings discredit to the school and community.
- Students will be representatives of their school and the deen of Allah in the community in which they live and will observe this conduct code at all times.
Note : Disregard for, or violation of, these standards will be dealt with according to the Student Discipline Policy
Student’s name: ______
Student’s signature: ______
Date: ______
Islamic Association of Arabi
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Tax ID 72-1128279