1001 Kalimah ِApplication Form
A self-paced family Arabic sight words learning program
Main Participant's Name
*
First Name
Last Name
Main Participant's Date of Birth
*
-
Month
-
Day
Year
Main Participant's Grade in 2020-2021
*
Preschool
KG
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
other
Gender
*
Female
Male
Parent's Name
*
First Name
Last Name
Email
*
Confirmation Email
example@example.com
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
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Alabama
Alaska
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California
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Connecticut
Delaware
District of Columbia
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Hawaii
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Louisiana
Maine
Maryland
Massachusetts
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New Hampshire
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Ohio
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Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Second Parent/Care Giver's Email
Confirmation Email
example@example.com
Participating sibling name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Participating sibling name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Allergies, Special Needs, and/or Accommodation Requests
Comments/Questions
Signature
*
I GIVE MY CHILD PERMISSION TO PARTICIPATE IN ALL KALIMAH ACTIVITIES. I UNDERSTAND THE RULES AND REGULATIONS FOR EACH ACTIVITY, AS EXPLAINED IN ANY WRITTEN OR EMAILED MATERIALS AND/OR EXPLAINED BY STAFF/VOLUNTEERS. I RELEASE, HOLD HARMLESS, AND INDEMNIFY KALIMAH AND ALL OF ITS STAFF, VOLUNTEERS, AND AFFILIATES FROM AND FOR ANY CLAIM, INJURY, OR OTHER LIABILITY OF ANY KIND WHICH IS CAUSED DIRECTLY BY PARTICIPANT, OR WHICH RESULTS FROM OR DURING MY CHILD'S PARTICIPATION IN THE PROGRAM. ON BEHALF OF THE CHILD/PARTICIPANT, I HEREBY CONSENT TO THE USE OF PHOTOGRAPHS, VIDEO FOOTAGE, AND ANY OTHER DIRECT OR INDIRECT REPRESENTATIONS OF THE PARTICIPANT IN PUBLICATIONS, WEBSITE, AND OTHER DIGITAL OR PRINT MEDIA BY, ABOUT, AND/OR RELATED TO KALIMAH.
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1 Year Full Access: quarterly packages & digital access ($90 saving!)
$
450.00
Full access for the 2021 calendar year. 1st Quarter starts January 16th and ends March 27th. Full access includes digital access plus a package sent in the mail each quarter containing sets of sight words as well as materials for hands-on, multi-sensory activities related to the word set and name art activities. Shipping physical packages is only available to participants in the United States of America. Arrangements to ship internationally may be made upon request with participant's agreement to cover all associated costs. Digital access includes memberships in and access to Kalimah's Google classroom, 3asafeer.com, and all other digital tools used during synchronous Zoom meetings (3/month on most months on Saturdays) and asynchronous work in between meetings.
Quarterly (full access)
$
135.00
Full access for one or more quarter. 1st Quarter starts January 16th and ends March 27th. Full access includes digital access plus a package sent in the mail each quarter containing sets of sight words as well as materials for hands-on, multi-sensory activities related to the word set and name art activities. Shipping physical packages is only available to participants in the United States of America. Arrangements to ship internationally may be made upon request with participant's agreement to cover all associated costs. Digital access includes memberships in and access to Kalimah's Google classroom, 3asafeer.com, and all other digital tools used during synchronous Zoom meetings (3/month on most months on Saturdays) and asynchronous work in between meetings.
Quantity
1
2
3
4
Quarterly (digital access only)
$
75.00
Digital access for one or more quarter. 1st Quarter starts January 16th and ends March 27th. Digital access includes memberships in and access to Kalimah's Google classroom, 3asafeer.com, and all other digital tools used during synchronous Zoom meetings (3/month on most months on Saturdays) and asynchronous work in between meetings.
Quantity
1
2
3
4
1 Year Digital Access Only (2 months free!)
$
250.00
Digital access for the calendar year 2021 Digital access includes memberships in and access to Kalimah's Google classroom, 3asafeer.com, and all other digital tools used during synchronous Zoom meetings (3/month on most months on Saturdays) and asynchronous work in between meetings.
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