Al-Rashid Islamic Institute                                  
New Student Application Form
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Email *
Applicant First Name *
Applicant Middle Name
Applicant Last Name *
FATHER'S / GUARDIAN'S FIRST NAME *
FATHER’S / GUARDIAN’S LAST NAME *
MOTHER’S / GUARDIAN’S FIRST NAME
 *
MOTHER’S / GUARDIAN’S LAST NAME *
STREET NUMBER *
STREET NAME *
APT/UNIT
CITY *
PROVINCE / STATE *
Postal Code / Zip Code *
DATE OF BIRTH *
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GENDER *
HEALTH CARD NUMBER (Include 2 letter version code for Ontario) *
PARENT/GUARDIAN CELL PHONE NUMBER *
PARENT/GUARDIAN HOME NUMBER *
FATHERS/GUARDIANS EMAIL *
MOTHERS/GUARDIANS EMAIL
Student's E-Mail
Student is living with? *
Is there a custody order in place for this student? *
When do you wish to commence studies? *
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Have you previously applied or have been registered at Al-Rashid? *
Which program(s) are you applying for? *
Required
Previous grade completed (e.g. Grade 1, Grade 2, High School Completed etc.) *
Are you fluent in English? *
Please select one of the following *
List present or previous school / Educational institute attended *
Please provide: Year Enrolled - Name of School- Grade/Program Completed - City/Country
Was the applicant expelled / suspended from any previous school? *
Does the applicant have a criminal record or any pending criminal charges? *
Do you have any allergies or medical conditions?
( including mental health disorders, learning disorders, ADHD etc.)
 *
If yes, please provide more information in the section below.
ALLERGY / MEDICAL CONDITION(S)  *
Provide information/details regarding the student's allergy or medical condition(s). If none please type "NONE"
The school fee is $3600.00 per year ($300 per month for 12 months).

I understand I will pay $50.00 to Al-Rashid for any payment declined to cover the Insuffecint Fund Fees Charged by the bank to the Institute. 
 *
I understand this is a new student waitlist / application form, which is valid for 1 year. I will be contacted only if I get approved for admission. *
I understand this application is only valid for one school year, if I dont get admission I have to reapply next year. *
RULES, REGULATIONS, AND POLICIES
1. The Student will be required to follow the sacred Shariah and Sunnah of the Holy Prophet Muhammad (sallallaho-alaihiwasallam) in all aspects of life at the Institute.

2. The student must practice acceptable manners of politeness and social behavior towards fellow-students, faculty, and staff of the Institute.

3. The student must have regard for the general cleanliness of the property and his dormitory.

4. The student will be permitted to leave the Institute only during vacations as determined by the Institute. The Principal may grant special leave when deemed necessary upon written request from a parent/guardian. The student must attend all classes and activities of the Institute unless permission is obtained from the principal.

5. The student is not permitted to own or use any small or major appliances, (Ex. toaster, fridge, microwave, deep fryer, etc.) media/entertainment devices, (Ex. video game devices, cell phones, audio, and video devices, etc.) or fitness equipment. (Ex. exercise bike, bench press equipment, etc.) If any of the fore-mentioned property is found, it will be confiscated and may be returned at the sole discretion of the principal. The data on any electronic devices may be subject to inspection; a student forfeits any privacy by possessing any electronic devices without prior permission. Under special circumstances, students may obtain explicit permission from the principal to own or use certain property.

6. All costs incurred as a result of the damaged Institute property caused by the student will be paid by the student/parent/guardian.

7. Al-Rashid is not responsible for any injury sustained by a student. The student is responsible for any medical or dental costs incurred. The damage or theft of personal property is also the sole responsibility of the student.

8. The student or parent/guardian must disclose any physical or mental disorders of the student before enrolling in the Institute.

9. The student or parent/guardian must disclose any history of involvement with the police or the judicial system.

10. Certain areas of the Institute are monitored by video cameras for the purpose of safety, prevention of criminal activity, and enforcement of the Institute’s rules and regulations. Any evidence collected thereby will be used in the investigation and prosecution of any criminal activity.

11. All new applicants may be subjected to a personal interview.  Students may also be subjected to an admission test in religious and secular school subjects.

12. The annual fee may be revised at the discretion of the Institute.

13. The student/parent/guardian agrees not to pursue any legal recourse should the student be subjected to correctional measures, including but not limited to detentions, suspensions, or expulsions.

14. Violation of any rules or regulations may be deemed sufficient for expulsion from the Institute at the principal’s discretion.
I certify that all statements on this application are correct and complete. I understand that my admission or registration is subject to cancellation at the sole discretion of the Institute. I agree with the rules, regulations, and policies listed above , as well as any additional requirements that may be imposed by the Institute. I understand that this application does not guarantee enrollment. I authorize the Institute to act as a legal guardian and make any decisions, including medical decisions on my/my child's behalf. *
eSignature of Student ( If student is over 18)
Please sign with your full name
Date of Student signature
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eSignature of Parent /Guardian *
Please sign with your full name
Date of Parent / Guardian signature *
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