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High School Pre-Registration Form
Please complete the required fields below to pre-register your child for the 9th grade. This information will help us in our planning for receiving your child August 2019. Pre-registration includes a $250 registration fee that is refundable. Refunds are only available in the event the 9th grade program does not begin August 2019. Parents will be notified if the 9th grade will not commence August 2019 no later than June. Please drop off your check or cash to the Al Iman School main office by Friday, April 5th, 2019.

Notice of Nondiscriminatory Policy

Al-Iman school admits students of any race, color, national origin, and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national origin and ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school-administered program.

Student First Name *
Your answer
Student Last Name *
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Student date of birth *
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Home Address - Street, City, State, Zip Code *
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Home Telephone *
Your answer
Students Previous School Name *
Your answer
1st Legal Guardian's Name *
Your answer
1st Legal Guardian's e-mail *
Your answer
1st Legal Guardian's phone number *
Your answer
2nd Legal Guardian's Name
Your answer
2nd Legal Guardian's e-mail
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2nd Legal Guardian's phone number
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Child lives with *
Does the child have any medical problems which the school should be aware of? If yes, please explain. *
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Is this a special needs student? *
Does the child have any regular medication? If yes, please explain. *
Your answer
Does the child have any allergies to specific foods or medications? If yes, please explain. *
Your answer
I hereby testify, to the best of my knowledge, that the above information is correct and accurate. *
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