New Student Registration
Student's Personal Details
Please ensure that all student details are correct and up to date.
Student's Information
Student's Full Name
*
First Name
Middle Name
Last Name
Student's Sex
*
Male
Female
Student's Date of Birth
*
-
Month
-
Day
Year
Date
Student's Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Student's First Language
*
Student's Educational History
Student's Previous School
*
Please Select
Public School
Catholic School
Private School
Home School
Canadian School (Outside Ontario)
School (Outside Canada)
Country of Previous School
Province of Previous School
Name of Previous School
Primary Language of Previous School
English
French
Other
Does the Applicant have an Individual Education Plan (IEP)?
Yes
No
Please Provide Details Regarding the Applicant's Individual Education Plan (IEP)
Was the Applicant Ever Suspended?
Yes
No
Please Provide Details Regarding the Applicant's Previous Suspensions.
Was the Applicant Ever Expelled?
Yes
No
Please Provide Details Regarding the Applicant's Previous Expulsions.
Enrolment Start Date
*
-
Month
-
Day
Year
What day would you like for the applicant to start attending Al-Risala Academy?
What Grade will the Applicant Attend at Al-Risala Academy?
Please Select
Pre-K (Montessori Program)
Junior Kindergarten (Montessori Program)
Senior Kindergarten (Montessori Program)
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
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Student's Health Details
Student's Health Coverage Plan
*
Ontario Health Insurance Plan (OHIP)
Other
Student's OHIP Card Number
*
Family Physician's Name
First Name
Last Name
Family Physician's Phone Number
Please enter a valid phone number.
Does the Student Have any Medical conditions and/or Allergies
*
Yes
No
Please List All of the Student's Medical Conditions and/or Allergies
*
Please list all medical conditions and/or allergies
Is the student taking medication(s) on a regular basis?
*
Please Select
Yes
No
What medication(s) does the student take on a regular basis?
*
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Primary Parent/Guardian Information
This person will be the main point of contact with Al-Risala Academy.
Primary Parent/Guardian's Full Name
*
First Name
Middle Name
Last Name
Primary Parent's Phone Number
*
Please enter a valid phone number
Primary Parent's Email
*
Confirmation Email
Please enter a valid email address
Primary Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parents' Information
Student Lives with (Custody Status):
*
Both Parent's
Mother
Father
Other
Father's Information
Father's Name
*
First Name
Middle Name
Last Name
Father's Phone Number
*
Please enter a valid phone number.
Father's Email Address
example@example.com
Mother's Information
Mother's Name
*
First Name
Middle Name
Last Name
Mother's Phone Number
*
Please enter a valid phone number.
Mother's Email Address
example@example.com
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Emergency Contacts
Please Note that we require the contact information of TWO (2) different emergency contacts
Emergency Contact #1
Emergency Contact's Name
*
First Name
Middle Name
Last Name
Emergency Contact's Relationship to Student
*
How is this emergency contact related to the student(s) you are registering?
Emergency Contact's Phone Number
*
Please enter a valid phone number.
Emergency Contact #2
Emergency Contact's Name
*
First Name
Middle Name
Last Name
Emergency Contact's Relationship to Student
*
How is this emergency contact related to the student(s) you are registering?
Emergency Contact's Phone Number
*
Please enter a valid phone number.
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Signature
Please verify that you are human
*
Submit
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