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Al-Arqam Islamic School & College Preparatory Application for Admission
Application for Admission for 2020-2021 Academic School Year
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Email
*
Your email
Grade Level Applying For:
*
Choose
Pre-Kindergarten (Pre-K)
Transitional Kindergarten (TK)
Kindergarten (KG)
1
2
3
4
5
6
7
8
9
10
11
12
Student Gender
*
Female
Male
Student Last Name
*
Your answer
Student First Name
*
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
Home Phone
Your answer
Father's Full Name
*
Your answer
Father's Cell Phone
*
Your answer
Father's Email Address
*
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
Your answer
Name of Previous School
*
Your answer
Previous School Address
*
Your answer
Previous School Phone Number
*
Your answer
Previous School Fax Number
*
Your answer
Has your child ever attended AIS/ACP?
*
Yes
No
If yes, when?
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Your answer
If your child attended, why did they leave?
*
Your answer
Does you child have any health conditions?
*
Yes
No
If so, what is the condition?
*
Your answer
Does your child take medication for the condition?
*
Your answer
Is there any special instructions regarding your child's condition during the visit?
*
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?
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Your answer
Was your child ever suspended from this school?
*
Yes
No
If so, why?
*
Your answer
Has your child ever been expelled from this or any school?
*
Yes
No
If so, why?
*
Your answer
A copy of your responses will be emailed to the address you provided.
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