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 *
Student First Name *
Student Date of Birth *
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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 AIS/ACP? *
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? *
Is there any special instructions regarding your child's condition during the visit? *
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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