ISM Noor Academy Daycare Enrollment Form

The Islamic Society of Michiana, whose vision is “to see a vibrant, well-educated, unique, moderate American Muslim community inspired by Qur’anic principles and prophetic ideals,” has initiated the development of a registered daycare ministry, ISM Noor Academy.

Mission: The mission of ISM Noor Academy is “to provide the tools to promote lifelong learning in an Islamic environment that inspires noble character and righteous leadership.”

Ages: ISM Noor Academy serves children ages 3-5. Children must be toilet-trained.

Hours of operation: Monday-Friday - 8:00 am – 5:00 pm

Admission Policies
The child care ministry shall accept only children who are at a stage of growth and development which enables them to benefit from its program, and for whose age level the daycare is staffed and equipped to provide care.

Summer break
ISM Noor Academy operates from August 31 to May 31. Summer programs may be offered. Please indicate if you are interested in summer programs for your child.

Parent Information

Please provide the mother's First and Last name.

Your answer

Please provide the father's First and Last name.

Your answer

Please provide the guardian's First and Last name. (if applicable)

Your answer

Street Address

Your answer

City

Your answer

State

Your answer

Zip Code

Your answer

Phone Number

Your answer

Alternative Phone Number

Your answer

Best contact email

Your answer

What are you most interested in?

Full Day Child Care

Half Day Child Care

What are you most interested in?

Two days a week

Three days a week

Four days a week

Full week

Are you interested in Summer Programs?

Yes

Which of the following would you feel comfortable using as a method of contact? (Check all that apply)

Facebook

Viber

Other:

Child Information (If you have multiple children, start with the oldest)

Child's First and Last Name

Your answer

Child's Date of Birth

YYYY

What are your child's interests? (Check all that apply)

Blocks

Books

Pretend Play

Toys (cars, animals, tools, etc.)

Drawing

Writing

Reading

Outside Play

Is your child toilet trained?

Yes

Work in progress

Does your child have dietary restrictions or allergies? (Check all that apply)

Halal

Gluten Free

Lactose Intolerance

Food Allergy (list under 'other')

Other:

Do you have another child to enroll?

Yes

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms

Forms