Ayat Academy Registration Form

Ayat Academy Registration Form

Ayat Academy

Enrollment
Date

MonthDayYear
Date
CHILD INFORMATION:
Child Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age
Grade*
Current School*
Charter School if Enrolled:
PARENT/GUARDIAN INFORMATION:
Mother's Name*

First NameLast Name
Father's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mother’s Phone Number*

Area CodePhone Number
Father’s Phone Number*

Area CodePhone Number
Mother's E-mail*
Father's E-mail*
example@example.com
Emergency Contact
Name

First NameLast Name
Phone Number

Area CodePhone Number
Signature (Printed Name)
By completing and submitting this form, you are officially registering your child for the 2025/2026 academic year. Please Zelle the required fees to complete registration and hold your child's spot.

Registration & Fees for 2025–2026:

Registration Fee: $200
Supply Fee: $95

Monthly Tuition: $750 (10% monthly discount per sibling)
Tuition Deposit: $1,500

*The tuition deposit is non-refundable and will cover two months of tuition. It will be applied to the final two months of the school year or to the two months following a withdrawal notice, if applicable. Ayat Academy does not retain this deposit.

Total Due at Registration: $1,795

Pay via Zelle: ayatacademyorg@gmail.com
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