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.
* Required
Email address
*
Your email
Parent Information
Please provide the Mother’s First and Last name.
Your answer
Please provide the Fatger’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
Clear selection
What are you most interested in?
Two days a week
Three days a week
Four days a week
Full week
Clear selection
Are you interested in Summer Programs?
Yes
No
Clear selection
Which of the following would you feel comfortable using as a method of contact? (Check all that apply)
Email
Facebook
WhatsApp
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
MM
/
DD
/
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
No
Work in progress
Clear selection
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
No
Clear selection
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
