Student Information
Student's Legal Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Student Email address
*
What is the gender of applicant?
*
Male
Female
What is the citizen status of the applicant?
*
Please Select
A lawful permanent resident (Alien)
A citizen or national of the United States
Noncitizen
An Alien authorized to attend public school in the US
Other
Has the applicant applied or attended any Muneer Academy program prior?
*
Yes
No
Which school term is the applicant applying for?
*
2026-2027
Which program is applicant applying for?
*
Hifdh Program
Aalimah Program (Girls Only) (Grades 6 - 12)
Which grade is the applicant applying for?
*
Please Select
4th
5th
6th
7th
8th
9th
10th
11th
12th
NA
Please select the grade in which you would like to have your child enrolled for at Muneer.
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Academic Educational Background
What is the last grade level the student has completed?
*
Name of Previous Academic School
*
Phone Number of Previous Academic School
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address of Previous Academic School
*
Please enter a valid phone number.
Address of Previous Academic School
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Has the applicant ever been involved in a serious infraction of school rules that caused them to be suspended, withdrawn, or expelled?
*
No
Yes
Has the applicant had any history of excess tardies or absences from school?
*
No
Yes
Please list and/or explain:
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Islamic Educational Background
Name of Previous Islamic Studies School
Phone Number of Previous Islamic Studies School
Format: (000) 000-0000.
Address of Previous Islamic School
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Primary Islamic Studies Teacher
Please indicate the type of program and how long the student was studying in the program.
Does the applicant know the entire Arabic alphabet?
*
No
Yes
Has the applicant completed Qa'idah?
*
No
Yes
Has the student completed reading the entire Holy Quran in Arabic?
*
No
Yes
Has the applicant completed Naazira/Tajweed?
*
No
Yes
How many Juz from the Holy Quran does the applicant memorized?
*
Student Reference
Provide an endorsement of a student's positive personal qualities, such as their work ethic, dependability, and enthusiasm. This may be an iman, teacher. mentor for the applicant. (OTHER THAN PARENTS AND RELATIVES)
Name of Reference
*
First Name
Last Name
Relation to Student
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Family Background Information
Why you would like your child to attend Muneer Academy?
*
How did you hear about Muneer Academy?
*
Father's Name
*
First Name
Last Name
Father's Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Father's Email
*
example@example.com
Mother's Name
*
First Name
Last Name
Mother's Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Email
*
example@example.com
Student Currently Lives With
*
Please Select
Both Parents
Mother
Father
Grandparents
Siblings
Other
Tuition Status
*
Please Select
Full-Tuition ($550/Month)
Apply for Scholarship (See Terms and Conditions)
Current Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Special Health and Medical Information
Medication can only be dispensed at school with a formal request signed by a doctor and parent.
Does the applicant have any history of health problems (physical, psychological, or emotional)?
*
Yes
No
Does the applicant have any type of learning disability, difficulty or limitations?
*
Yes
No
Is the applicant currently prescribed any medication?
*
Yes
No
Check all that apply regarding student's health condition
*
Asthma
Vision/Glasses
Speech Impairment
Autism
Hearing
Diabetes
Hemophilia
ADHD
Heart Problem
Allergies (list below)
Food Restrictions (list below)
Learning Disability
Seizure Disorder
Physical Disability
Psychological Disorder
None
Other
Please list and explain condition, including any prescribed medication, and dosage.
If your child receives daily medication, AT HOME OR AT SCHOOL, please list the name of the medication, dose, and time it is given.
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Emergency Contact
In the event of an emergency, please list the name and telephone number of individual you would like us to contact. (OTHER THAN PARENTS)
Emergency Contact #1
*
First Name
Last Name
Relationship to Student (Emergency Contact #1)
*
Phone Number (Emergency Contact #1)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2
*
First Name
Last Name
Relationship to Student (Emergency Contact #2)
*
Phone Number (Emergency Contact #2)
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Terms of Application
Admission decisions are based on a wide range of considerations and are solely and exclusively the right of Muneer Academy to decide.
*
I do hereby affirm that, to the best of my knowledge, all statements made on this application are true and complete.
I do hereby affirm that if my child is accepted into Muneer, we will follow all school guidelines and rules outlined in the Parent and Student Handbook or otherwise stated.
I do hereby affirm that if my child is accepted into Muneer, we will accept all school fee charges.
I understand that any falsification herein could result in immediate dismissal of applicant.
I understand that this application does not guarantee admission of applicant.
All information on this form is true and accurate to the best of my knowledge.
I authorize access to all school records and further authorize communication with the school(s) listed in this application.
I understand that the student's admission to Muneer Academy will be solely at the discretion of the Admission Committee.
Application Documents
Photocopy of Michigan Immunization Records (MCIR Number Must Be Visible)
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Photocopy of Birth Certificate
*
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