NEW STUDENT 2026-27 Pre-Registration Form
Thank you for your interest in Burhan Academy for your children's education. Please fill out this form, upload documents, choose an assessment date, and pay the $150 registration fee.
Parent/Guardian Information
Father's Name
*
First Name
Last Name
Mother's Name
*
First Name
Last Name
Father's Email
*
example@example.com
Mother's Email
*
example@example.com
Father's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact 1
*
First Name
Last Name
Relationship to student/s
*
Emergency Contact 2
*
First Name
Last Name
Relationship to student/s
*
Emergency Phone Number 1
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Phone Number 2
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School district of residence
*
Primary care physician/pediatrician name
*
Dentist's name
Primary care physician/pediatrician Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
is English your child's/children's first language?
*
Please Select
No
Yes
Primary language spoken at home?
*
How many children are you registering?
*
Please Select
1
2
3
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Student Information
Student 1
Legal Name (as on the birth certificate)
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Place of Birth (city, state, country)
*
Student Race (ISBE categories)
*
American Indian or Alaska native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Student lives with
*
Please Select
Mother & Father
Mother
Father
Foster Parent
Other Guardian
Does the student have:
*
Diabetes
Seizure Disorder
Asthma
Allergies
None of the above
Other
Please explain any allergies or medical conditions here.
Does the student take medication during school hours?
*
Please Select
No
Yes
If so, mention medication name, dosage, and timing
Grade Level for Enrollment at Burhan Academy
*
Please Select
PreSchool Half Day (3-year-olds)
PreSchool Full Day (3-year-olds)
PreK Full Day (4-year-olds)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
Previous school name and address. If your child has been home schooled or never been to school before, please mention it here.
*
Has this student ever been retained in a class?
*
Please Select
No
Yes
Has the student ever received academic intervention services?
*
Please Select
No
Yes
Does the student have an IEP?
*
Please Select
No
Yes
Does the student have a 504 Plan? If yes, please provide a copy.
*
Please Select
No
Yes
Student 2
Legal Name (as on the birth certificate)
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Place of Birth (city, state, country)
*
Student Race (ISBE categories)
*
American Indian or Alaska native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Student lives with
*
Please Select
Mother & Father
Mother
Father
Foster Parent
Other Guardian
Does the student have:
*
Diabetes
Seizure Disorder
Asthma
Allergies
None of the above
Other
Please explain any allergies or medical conditions here.
Does the student take medication during school hours?
*
Please Select
No
Yes
If so, mention medication name, dosage, and timing
Grade Level for Enrollment at Burhan Academy
*
Please Select
PreSchool Half Day (3-year-olds)
PreSchool Full Day (3-year-olds)
PreK Full Day (4-year-olds)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
Previous school name and address. If your child has been home schooled or never been to school before, please mention it here.
*
Has this student ever been retained in a class?
*
Please Select
No
Yes
Has the student ever received academic intervention services?
*
Please Select
No
Yes
Does the student have an IEP?
*
Please Select
No
Yes
Does the student have a 504 Plan? If yes, please provide a copy.
*
Please Select
No
Yes
Student 3
Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Place of Birth (city, state, country)
*
Student Race (ISBE categories)
*
American Indian or Alaska native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Student lives with
*
Please Select
Mother & Father
Mother
Father
Foster Parent
Other Guardian
Does the student have:
*
Diabetes
Seizure Disorder
Asthma
Allergies
None of the above
Other
Please explain any allergies or medical conditions here.
Does the student take medication during school hours?
*
Please Select
No
Yes
If so, mention medication name, dosage, and timing
Grade Level for Enrollment at Burhan Academy
*
Please Select
PreSchool Half Day (3-year-olds)
PreSchool Full Day (3-year-olds)
PreK Full Day (4-year-olds)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
Previous school name and address. If your child has been home schooled or never been to school before, please mention it here.
*
Has this student ever been retained in a class?
*
Please Select
No
Yes
Has the student ever received academic intervention services?
*
Please Select
No
Yes
Does the student have an IEP?
*
Please Select
No
Yes
Does the student have a 504 Plan? If yes, please provide a copy.
*
Please Select
No
Yes
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Please upload the required documents for EACH CHILD here. 1. Birth Certificate. 2. DENTAL: If your child is enrolling in KG, 2nd, 6th, or 9th grade, we would need this form filled and signed by a dentist and dated 2/17/26 or later. 3. PHYSICAL: If your child is enrolling in PreSchool, KG, 6th, or 9th grade we would need a physical dated 8/18/25 or later. Please remember to fill and sign the parent portion on top. 4. OPTICAL: If your child is enrolling in KG or is a NEW student at Burhan, we would need a vision exam dated 8/18/25 or later. Please see the pics below to confirm you submit the standard Illinois state health forms that all doctor's offices already have.
*
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If you are enrolling for PreSchool (3-year-olds), please choose full or half day. We are NOT offering a half-day option for Pre-K (4-year-olds) in 2026-27.
*
Please Select
Full Day Preschool 8am-3:15pm
Half Day Preschool 8am-11:30am
Not Applicable
In case of an emergency, I authorize Burhan Academy to get medical treatment for my child/children
*
Please Select
Yes I do
No I do not
I authorize Burhan Academy to give my child/ren over the counter medication like Tylenol if needed
*
Please Select
Yes I do
No I do not
I authorize Burhan Academy to give my child/ren prescription medication if the parents have provided it, in special cases.
*
Please Select
Yes I do
No I do not
I authorize Burhan Academy to use my children's photos for the Yearbook, Class Dojo, social media, website etc.
*
Please Select
Yes to all
Only Yearbook
Only Class Dojo
Only Class Dojo and Yearbook
No permission for any photos
Only the following people are authorized to pick up my children.
*
I understand I need to provide the school with ALL my child's required documents before registration is confirmed. We require a birth certificate and Illinois standard state forms for physical, vision, dental exams dated August 2025 or later.
*
Please Select
Yes, I understand
I understand in order to complete registration, there needs to be no unpaid balance in my OPENSIS account.
*
Please Select
Yes, I understand
Please choose a date for assessment. 1st Grade and up will have a computerized assessment. KG students will have a teacher to help with the assessment. Please come to the Abu Hanifa Center at 322 Kimball St, Elgin IL 60120 for the test. You can walk in anytime between 10am-noon. The reading and math test takes approximately 45 min.
*
Wednesday Aug 26 (1st Grade and up)
Thursday Aug 27 (1st Grade and up)
I am unavailable on all the above dates (I understand that seats may fill up by the next assessment date)
I understand submitting this form confirms my child/ren are PRE-registered. This does not complete registration. I will receive an email from the school once they have confirmed I have submitted all documents. We will send the updated handbook separately for electronic signatures, Your child's seat will be confirmed once we have received the first month's tuition (or full annual tuition) and curriculum fee. The last day to pay those fees is July 1, 2026.
*
Please Select
Yes, I understand
Parent signature
*
Full name of parent signing
*
First Name
Last Name
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Admin Use Only
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Discount2
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Registration Fees
You are registering {howMany} student(s). Please proceed to payment to complete the payment.
Registration Fees for Students
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USD
Non-Refundable registration fees for school year 2026-2027 Pre-School- 9th Grade
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