All students' applications must be filled out entirely to complete the registration.
Parents should submit copies of the following records: Medical Assessment Birth Certificate Immunization Record
FAMILY INFORMATION (*Needed for Jupiler grades)
I permit the school to send school updates as text messages.
GUARDIANS' INFORMATION: If a student does not live with their parents. Stepparents. guardians. or sponsors (if applicable):
Stepparents, guardians, or sponsor's information (if applicable):
I,the undersigned, permit school officials to act on my behalf in emergencies to obtain medical treatment for my child. I agree to accept full responsibility for paying all ambulance, hospital, and physician's bills or charges for any services rendered.
Indicate the person other than parents to be contacted in case of an emergency:
All parents are required to complete 10 hours of mandatory school service during the academic year. Please check the type of service you will provide.
Assisting with CI Academy Fundraising events. Being a Homeroom Parent Picture day Event (once a year for a day) Hajj Program Quran Competition Graduation (Preparation and the actual day) Science Fair Day (All Day) Assisting classroom teachers (i.e copying. collating papers) Teaching extra-curricular programs once a week (computer skills, sewing, arts & crafts, Quran, Arabic, sports, other) Cleanup - (re-arrange classrooms, dusting. cleaning. etc Painting various rooms in the building. Other:
Parents should submit copies of the following records:
By signing this application, I agree to abide by the policies and regulations of Charlotte Islamic Academy. To the best of my knowledge. the information I have given is accurate. I understand that any misrepresentation of facts on this application may cause for the refusal of admission, financial aid, cancellation of admission, or suspension from the school.
Iunderstand that if my child withdraws or transfers to another school, transcripts from Charlotte Islamic Academy will be withheld until all past-due fees, fines, and tuition are settled.
List in priority order of parents or people the Academy should contact in case of an emergency. (Only if they live in Charlotte, NC)
1st Contact info
2nd Contact info
3rd Contact info
4th Contact info
List in priority order the names of the persons (including parents) authorized to sign the child of school. Photo identification is required for students pickup.
Please put a checkmark in front of any condition if that applies to your child