Al-Arqam Islamic School & College Preparatory Application for Admission
Application for Admission for 2020-2021 Academic School Year
Email address *
Grade Level Applying For: *
Student Gender *
Student Last Name *
Your answer
Student First Name *
Your answer
Student Date of Birth *
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Home Address *
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Home Phone
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Father's Full Name *
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Father's Cell Phone *
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Father's Email Address *
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Mother's Full Name *
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Mother's Cell Phone *
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Mother's Email Address *
Your answer
Primary Language Spoken at Home
Your answer
Name of Previous School *
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Previous School Address *
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Previous School Phone Number *
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Previous School Fax Number *
Your answer
Has your child ever attended AIS/ACP? *
If yes, when? *
Your answer
If your child attended, why did they leave? *
Your answer
Does you child have any health conditions? *
If so, what is the condition? *
Your answer
Does your child take medication for the condition? *
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Is there any special instructions regarding your child's condition during the visit? *
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Does your child have a current 504 plan or IEP? *
If so, what services were last provided? *
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Was your child ever suspended from this school? *
If so, why? *
Your answer
Has your child ever been expelled from this or any school? *
If so, why? *
Your answer
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