Ayah Academy - New Student Application Form

Ayah Academy - New Student Application Form
Ayah Academy is a full-time Islamic school rooted in Islamic values and anchored in a Quranic worldview, guiding children on their learning journey while nurturing academic excellence, strong character, and a lifelong love of learning.

Early Childhood (Ages 2.5–5)
A fully Montessori Islamic program that nurtures independence, curiosity, and joyful learning in a faith-centered environment designed to support each child's academic, social, emotional, and spiritual growth.

Grades 1–3
A traditional elementary program that provides a strong academic foundation within a nurturing Islamic environment. Small class sizes and low student-to-teacher ratios ensure that every child is known, supported, and challenged. Through targeted small-group instruction and personalized attention, students build confidence, strengthen core academic skills, develop critical thinking, and grow in character while cultivating a lifelong love of learning.
- Parent 1 - Father
  
  First NameLast Name
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Parent 2 - Mother
  
  First NameLast Name
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Relationship to Student
- Authorized to Pickup
- Name
  
  First NameLast Name
- Birth Date
  
  MonthDayYear
- Gender
- Grade Enrolling for 2026-2027 School Year
- What grade was your child in during the 2025–2026 school year? (Last grade completed)
- Previous School Name
- Previous School Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Does your child have any allergies?
- If YES, please explain.
- Primary Doctors Name
- Primary Doctors Phone Number
- Does your child have health insurance?
- Insurance Name
- Insurance Member ID Number
- Upload Your Child's Birth Certificate
- Upload Your Child's Immunization Record
- Would you like to enroll another child?
- Name
  
  First NameLast Name
- Date of Birth
  
  MonthDayYear
- Gender
- Grade Enrolling for 2026-2027 School Year
- What grade was your child in during the 2025–2026 school year? (Last grade completed)
- Previous School Name
- Previous School Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Does your child have any allergies?
- If YES, please explain.
- Primary Doctors Name
- Primary Doctors Phone Number
- Does your child have health insurance?
- Insurance Name
- Insurance Member ID Number
- Upload Student 2 Birth Certificate
- Upload Student 2 Immunization Record
- Would you like to enroll another child?
- Name
  
  First NameLast Name
- Date of Birth
  
  MonthDayYear
- Gender
- Grade Enrolling for 2026-2027 School Year
- What grade was your child in during the 2025–2026 school year? (Last grade completed)
- Previous School Name
- Previous School Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Does your child have any allergies?
- If YES, please explain.
- Primary Doctors Name
- Primary Doctors Phone Number
- Does your child have health insurance?
- Insurance Name
- Insurance Member ID Number
- Upload Student 3 Birth Certificate
- Upload Student 3 Immunization Record
- Parent/Guardian Agreement:
  - I/We affirm that all information provided in this application is accurate, complete, and truthful.
  - I/We understand that admission to Ayah Academy is contingent upon school review, policy compliance, and space availability.
- Signature
- Date
  
  MonthDayYear
  Date
Should be Empty: