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Al-Arqam Islamic School & College Preparatory 2023-2024 Application for Admission
Admission for the 2023-2024 Academic School Year
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Email
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Your email
Grade Level Applying For:
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PreK
Transitional Kindergarten
Kindergarten
first grade
second grade
third grade
fourth grade
fifth grade
sixth grade
seventh grade
eighth grade
ninth grade
tenth grade
eleventh grade
Student Gender
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Female
Male
Student Last Name
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Your answer
Student First Name
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Your answer
Student Date of Birth
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DD
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YYYY
Home Address
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Your answer
Home Phone
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Your answer
Father's Full Name
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Your answer
Father's Cell Phone
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Your answer
Father's Email Address
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Your answer
Mother's Full Name
*
Your answer
Mother's Cell Phone
*
Your answer
Mother's Email Address
*
Your answer
Primary Language Spoken at Home
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Your answer
Name of Previous School
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Your answer
Previous School Address
*
Your answer
Previous School Phone Number
Your answer
Previous School Fax Number
Your answer
Has your child ever attended Al-Arqam Islamic School Before ?
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Yes
No
If yes, when?
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DD
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If your child attended, why did they leave?
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Your answer
Does you child have any health conditions?
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Yes
No
If so, what is the condition?
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Your answer
Does your child take medication for the condition? If yes, please indicate the name for the medication.
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Your answer
Is there any special instructions regarding your child's condition?
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Your answer
Does your child have a current 504 plan or IEP?
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Yes
No
If so, what services were last provided?
Your answer
Was your child ever suspended from this school?
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Yes
No
If so, why?
Your answer
Has your child ever been expelled from this or any school?
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Yes
No
If so, why?
Your answer
A copy of your responses will be emailed to the address you provided.
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