AL Huda Islamic School-Online Admission Form

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(310) 973-0500

American Leaders with a clear Islamic identity

Online Application

Student Information

First Name
Last Name
Middle Name
Gender		Male Female
Address
City
State
Zip Code
Home Phone Number
Place Of Birth
Date Of Birth
Grade For -
School Last Attended
Address
City
State
Zip Code
Phone Number
Any health concerns/allergies
Was student referred for evaluation due to academic, behavioral, or emotional difficulties?		No Yes

Parent's Information

Father's Name
Occupation
Work Phone Number
Beeper or Cell Pone
Email address
islamics Proficiency		Reading Writing Speaking
Arabic Proficiency:		Reading Writing Speaking
Mother's Name
Occupation
Work Phone Number
Beeper or Cell Pone
Email address
islamics Proficiency		Reading Writing Speaking
Arabic Proficiency		Reading Writing Speaking
Applicant lives with		Father Mother Both Other

Emergency Contact Information
Please list two relatives or neighbors who will assume temporary care of your child if you cannot be reached in case of emergency

Name-1
His/Her Phone Number
Name-2
His/Her Phone Number
Please list any health concern or allergies
Affidavit
In case of accident or illness, I understand that the school will contact me. If the school is unable to reach me in an emergency, I understand that the school may take the necessary action to help my child, including taking my child to the nearest hospital. I list my physician's name and phone number in case it would be needed.

Physician's Name
His/Her Phone Number
Parent’s Name
His/Her Phone Number

*The following policies apply to all New and Returning students: The tuition for the 2008-2009 school years: One Child $450 Two Children $ 725 Three Children $ 940 Four Children $1,110 Application fee for students = $50 Supplies fee for students = $250 One-time Textbooks and Materials Fee: Kindergarten $250 Grades 1-5 $300 Grades 6-8 $350 Registration, Supplies and Books fee are due at the time of application submission. All fees are non-refundable and secure your child’s place for the coming year. In case of traveling, leaving school or vacation you still have to pay full tuition till June. Tuition is due at the 1st day of the month. There will be a $30.00 late fee after the 10th of the month. If the tuition is not received by the 15th of the month the students will not be allowed to attend the school until the tuition is paid. New students should submit the following for each child: Proof of Birth Date…Birth Certificate Immunization Record…all Immunizations should be up to date Health Check-Up Form…all students beginning school TB Test Results Language Survey, Family Survey …all students Al-Huda Database and Emergency Card
I accept and agree to abide by the policies stated above and Al-Huda Islamic School Rules and Regulations.

	Excellent academia
	Arabic Language
	Clear Islamic Identity
	Very High SAT scores
	Private school environment
	Science Fair finalist for State & count
	Prime Location. 10 minutes away from LAX.

No Spam No selling of Email
100% Gurantee

Kindly fill in the application form online, for more queries, call us or email us