Spring 2011
Registration Form
1. Fathers Name (First, Last):-------------------------------- Email: -------------------------------
2. Mothers Name (First):-------------------------------------- Email: -------------------------------
Parent is a Student: yes or no [Please circle one]
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# of Children
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Parent a Student/ Please Pay
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Parent a Resident/ Please Pay
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One Child
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$115
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$170
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Second Child
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$95
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$150
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After the Second Child
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$85
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$140
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School Use Only/Don’t Fill In Fees
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#
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Child’s First Name
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Child’s Last Name
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Exact Date of Birth
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Sex (M/F)
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Known Allergies
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Tuition Fee Amount Paid
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If Paying by Check please indicate:
Check #
Donation
$----------
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1
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2
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3
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4
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5
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3. Address: ------------------------------------ -----------------------------------------------------
4. Home phone number: ---------------------------- 5. Cell phone: ------------------------------
6. In case of emergency, whom to contact other than the parents?
Name: ----------------------------------------- Telephone: -------------------------------------------
7. Native Language: --------------------------------------------
Donations Needed: For those parents who are financially able, we would appreciate your help, by sponsoring a student who cannot afford tuition. Just include the donation in your registration envelope with the number of children you would like to sponsor. The Spring 2011 session will cost the school more than $130 per child, this includes book fees. Some families in our community will have a hard time to cover these fees. Your help will be greatly appreciated.
I acknowledge the discipline policy and guidelines mentioned in the SPRING 2011 registration packet, and agree to its terms.
_______________________________ _________________________
Printed Name of Parent Signature
Questions and suggestions are highly encouraged. In order for us to address issues appropriately all suggestions and comments must be in writing, via email, or handwritten.
Contact Information:
Walid Sharabati, IEB Coordinator wsharaba@purdue.edu
Sereen Alkhalili, Principal salkhali@purdue.edu
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Rules – Please initial each rule and sign this agreement below
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· Students must bring backpack, books, ASSIGNED folder, & pencil to each session. _________
· Folders must be signed each week. ________
· Arriving on time will NOW BE REQUIERED for every student. In the event that your child arrives for school AFTER 10:05am more than THREE TIMES during the semester, your child will be EXPELLED from the school. ________
· If your child is sick or you are going out of town, you must either email Muslimkidss@yahoo.com, salkhali@purdue.edu prior to the absence, or call 765-496-4667 & leave a message. ________
· TWO NO-CALLS & TWO NO-SHOWS, you will receive a WARNING in the mail. 3 NO-CALLS & NO SHOWS will result in your child/children being withdrawn from the class list and you will be required to re-register them for the semester if you wish for them to continue. ________
· ALL CLASSES WILL HAVE REQUIRED HOMEWORK EACH WEEK. I (Sereen Alkhalili) will be holding a tutoring session in the Multi-purpose room by appointment to aid students in their homework preparation for Sunday IF NEEDED. Students who CONTINUE to come to school WITH OUT HOMEWORK will be EXPELLED after THREE TIMES. ________
· Teachers, Students & Visitors are required to remove their shoes at the door and place in the shoe racks. ________
· Students may wear socks, leather socks or slippers in the Islamic School, but ALL SHOES worn OUTSIDE must stay in racks. _________
· There will be absolutely NO: pushing, shoving, touching, bad words/language or bullying TOLERATED!! ________
· When a student disrupts their class OR having fight with other students, he/she will be warned by their teacher, on the second warning the student will be dismissed from the class and sent to the principal for evaluation of the problem. Upon returning to class, if the student continues to disobey the teacher, the student will then be directed back to the principal. At this point the parents will be telephoned to PICK UP their child from the school immediately. We will WELCOME the student back for the next school day, but this process will be repeated until the child can observe the rules in an organized school setting. _________
Please DO NOT let your child bring any toys, game boys or electronic games to Islamic School. These will be confiscated and can only be picked up by the parent. ________
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Name of Student(s): __________________________
I have read and understand the expectations of the Student Agreement:_____________________________________
