Hidaya Academy Enrollment Form 2026-2027

Student Information
Student's Preferred Language of Instruction
Does the student have any medical conditions or allergies?

Other
If Other, please explain
Please describe the other condition.
Any additional notes or special needs?

Add any important details.0/250
Will you submit previous academic records?
How did you hear about Hidaya Academy?
Student Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Student Address

Street Address

Apartment, suite, etc.
CityState/ProvinceZIP Code
Previous School
Enter the name of the most recently attended school.
Previous School Address

Street Address

Apartment, suite, etc.

CityState/Province

ZIP Code
Primary Guardian Name

First NameMiddle NameLast Name
Primary Guardian Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Primary Guardian Email
Enter a valid email address.
Same as Student Address (Primary Guardian)
Primary Guardian Household Address

Street Address

Apartment, suite, etc.

CityState/Province

ZIP Code
Primary Guardian Relationship to Student
Secondary Guardian Name

First NameMiddle NameLast Name
Secondary Guardian Phone Number
Enter a valid phone number.Format: (000) 000-0000.
Secondary Guardian Email
Enter a valid email address.
Same as Student Address (Secondary Guardian)
Secondary Guardian Household Address

Street Address

Apartment, suite, etc.

CityState/Province

ZIP Code
Student Grade Level

Student Information