IANT QURANIC ACADEMY Re-enrollment 2021-2022
Please complete each item carefully and pay a re-enrollment fee of $100/ child here:https://myiqa.org/donate. Your re enrollment will be confirmed only when you submit the form with the payment.
Today *
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Student's Name *
Current Level *
Grade enrolling to:
Student's Name
Current Level
Grade enrolling to:
Student's Name
Current Level
Grade enrolling to:
Please check one box:
Please provide a reason for not returning or being unsure at this time
I hereby:
Please read carefully below:
In the event, my child becomes ill or is injured at school and cannot be reached. IANT Quranic Academy is authorized to contact the person(s) listed on Student Emergency Card, or take my child to the physician indicated, or to a hospital and is given consent foe emergency care depending on the severity of the illness or injury. The Academy is not responsible for any emergency care and transportation.
Please fill out the following information only if there is a change:
Legal Name of Father/Guardian
Place of employment
Business telephone
E-mail Address
Mobile
Skills Father can volunteer to IQA
Legal Name of Mother/Guardian
Place of employment
Business telephone
Email Address
Mobile
Skills Mother can volunteer to IQA
Home Address
Home Telephone Number
My child may be released to the following person(s) only
Relationship to student
Phone Number
Name
Relationship to student
Phone Number
Local Doctor Name
Phone Number
Address
List health conditions, such as heart disease, diabetes, seizures, asthma, severe food or drug allergies, eye ear problems, chronic illness, etc and any medications student takes.
Payment for the re-enrollment
Please make sure you make payment of $100 per child by clicking on the link https://myiqa.org/donate. Your seat will not be confirmed unless you make the re enrollment payment.
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