Miraaj Academy - Admission Application

Application for the Sacred Seeds Elementary Program
Applicant Information
Student's Name

First NameMiddle NameLast Name
Address

Home Address

Street Address Line 2

CityState/Province

Zip/Postal CodeCountry
Age
Date of Birth (Mo/Day/Year)

MonthDayYear
Date
Country of Birth
Country of Citizenship
Home Telephone (include country, city, and area codes)
Cell Number (include country, city, and area codes)
Current Grade Level
GPA
What type of school is your child currently attending?

HomeschoolPublic SchoolIslamic Private SchoolOther Private School
Is the student's address the same as the parents address

YesNo
Check if appropriate

Parents are marriedParents are divorced
If parents are divorced, who has legal custody of the applicant?

Parent Communications

	Father	Mother	Both Parents
Where should bills be sent?
Where should we send school materials?

Admission Questionnaire
Is the student currently memorizing Quran?

YesNo
How much of the Quran is the student able to memorize in a day? (ex 2 ayats, 1 page ..)
1. Please list the surahs or the number of ajza the student has memorized
2. Describe the student's level of proficiency with reading and writing Arabic
3.What books has the student read in the past year?