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Special Needs Weekend School Program Interest Form
The Mecca Center in partnership with MUHSEN is striving to serve the Islamic Education Needs of community members with special needs. Please complete this form if you are interested in learning more about enrolling your child in an Islamic weekend school program that serves children of all abilities. Any information you can provide will help us better serve you and your loved ones with special needs.
Student Name *
Age *
Gender *
Parents Names *
Email address *
Phone number *
City and State of residence *
Primary Disability Diagnosis *
Describe your child's current full time school placement
Clear selection
Describe your child's current academic setting *
What type of supports does your child require in an education setting? *
What are your goals for your child in regard to islamic weekend school? What do you hope for them to accomplish? *
Other beneficial information about your child
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