Al-Arqam Islamic School & College Preparatory Application for Admission
Admission for 2020-2022 Academic School Year
Email address *
Email address *
Grade Level Applying For: *
Student Gender *
Student Last Name *
Student First Name *
Student Date of Birth *
Home Address *
Home Phone *
Father's Full Name *
Father's Cell Phone *
Father's Email Address *
Mother's Full Name *
Mother's Cell Phone *
Mother's Email Address *
Primary Language Spoken at Home *
Name of Previous School *
Previous School Address *
Previous School Phone Number
Previous School Fax Number
Has your child ever attended Al-Arqam Islamic School Before ? *
If yes, when?
If your child attended, why did they leave? *
Does you child have any health conditions? *
If so, what is the condition? *
Does your child take medication for the condition? If yes, please indicate the name for the medication. *
Is there any special instructions regarding your child's condition? *
Does your child have a current 504 plan or IEP? *
If so, what services were last provided?
Was your child ever suspended from this school? *
If so, why?
Has your child ever been expelled from this or any school? *
If so, why?
A copy of your responses will be emailed to the address you provided.
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