Admission Form 2023-24 | Al Falah Islamic School

Note
* Please have all documents ready for upload as there is no way to save progress on the form.

REGISTRATION FORM

SECTION A STUDENT INFORMATION (01)

Student ID Number *

Student Type *

Name *

First

Last

Date of Birth *//

Gender *

Male
Female

Grade in September *

Other Fee(s)
* Admission fee per new student $250
** Supply fee per student $350
*** Evaluation test fee applies to new students only for Grades 1-8 $150

Other Fee(s)
Supply fee per student $350

Monthly Tuition Fee
Montessori Program Casa [Junior (4 year old) and Senior (5 year old)] Monthly Tuition & Fee is $735.00

Monthly Tuition & Fee for Grade 1-8 is $650.00

* Monthly tuition is deducted for 10 months

INCLUDES: Workbooks, photocopied materials, art supplies (paint, paint brushes, pastel paint, and construction paper), Montessori supplies, Chromebooks, STEM and coding program.

DOES NOT INCLUDE: Stationery, notebooks, duo tangs, folders, binders, and tissue boxes.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

First Language Spoken at Home *

Country of Birth *

Entry Date to Canada

(Only if birth country is not Canada)

Child Lives With *

Both parents
Mother
Father
Guardian

Upload Copy of Custody/Guardian Papers

Click or drag a file to this area to upload.

Name of Current School *

Example: Al-Falah Islamic School

School Phone

Has your child ever been on Individual Education Program? *

Has your child ever been suspended? *

If yes, please explain

SECTION B STUDENT' S EMERGENCY INFORMATION (01)

Child’s Health Card *

Doctor's Name *

Doctor's Phone *

Does your child have allergies? *

If Yes, does your child have an EpiPen?

Is EpiPen submitted to the office?

List of Allergies

Does your child take any medication regularly? *

If yes, name, dosage and reason for the medication

Does your child have any Dietary Restrictions? *

Dietary Restriction (if any)

Layout

Attach Birth Certificate *

Click or drag a file to this area to upload.

Attach Health Card Copy *

Click or drag a file to this area to upload.

Attach Immunization Record *

Click or drag a file to this area to upload.

(02) Do you have more children attending Al Falah?

Add Another Student
Do Not Add Student

SECTION A STUDENT INFORMATION (02)

Student Type (02) *

Name *

First

Last

Date of Birth *//

Gender *

Male
Female

Grade (of Student 2) in September *

Other Fee(s)
* Admission fee per new student $250

** Supply fee per student $350

*** Evaluation test fee applies to new students only for Grades 1-8 $150

Other Fee(s)
Supply fee per student $350

Monthly Tuition Fee
* 10% discount will be applied by the school to the lowest monthly tuition fee(s)

Montessori Program Casa [Junior (4 year old) and Senior (5 year old)] Monthly Tuition & Fee is $735.00

Monthly Tuition & Fee for Grade 1-8 is $650.00

* Monthly tuition is deducted for 10 months

INCLUDES: Workbooks, photocopied materials, art supplies (paint, paint brushes, pastel paint, and construction paper), Montessori supplies, Chromebooks, STEM and coding program.

DOES NOT INCLUDE: Stationery, notebooks, duo tangs, folders, binders, and tissue boxes.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

First Language Spoken at Home *

Country of Birth *

Entry Date to Canada

(Only if birth country is not Canada)

Child Lives With *

Both parents
Mother
Father
Guardian

Upload Copy of Custody/Guardian Papers

Click or drag a file to this area to upload.

Name of Current School *

School Phone

Has your child ever been on Individual Education Program? *

Has your child ever been suspended? *

If yes, please explain

SECTION B STUDENT' S EMERGENCY INFORMATION (02)

Child’s Health Card *

Doctor's Name *

Doctor's Phone *

Does your child have allergies? *

If Yes, does your child have an EpiPen?

Is EpiPen submitted to the office?

List of Allergies

Does your child take any medication regularly? *

If yes, name, dosage and reason for the medication

Does your child have any Dietary Restrictions? *

Dietary Restriction (if any)

Layout

(03) Do you have more children attending Al Falah?

Add Another Student
Do Not Add Student

SECTION A STUDENT INFORMATION (03)

Student Type (03) *

Name *

First

Last

Date of Birth *//

Gender *

Male
Female

Grade (of student 3) in September *

Resource fee & entrance fee per student is added

Grade (of student 3) in September *

*Including Annual Supply & Evaluation Test fee per student

Other Fee(s)
* Admission fee per new student $250

** Supply fee per student $350

*** Evaluation test fee applies to new students only for Grades 1-8 $150

Other Fee(s)
Supply fee per student $350

Monthly Tuition Fee
* 10% discount will be applied by the school to the lowest monthly tuition fee(s)

Montessori Program Casa [Junior (4 year old) and Senior (5 year old)] Monthly Tuition & Fee is $735.00

Monthly Tuition & Fee for Grade 1-8 is $650.00

* Monthly tuition is deducted for 10 months

INCLUDES: Workbooks, photocopied materials, art supplies (paint, paint brushes, pastel paint, and construction paper), Montessori supplies, Chromebooks, STEM and coding program.

DOES NOT INCLUDE: Stationery, notebooks, duo tangs, folders, binders, and tissue boxes.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

First Language Spoken at Home *

Country of Birth *

Entry Date to Canada

(Only if birth country is not Canada)

Child Lives With *

Both parents
Mother
Father
Guardian

Upload Copy of Custody/Guardian Papers

Click or drag a file to this area to upload.

Name of Current School *

School Phone

Has your child ever been on Individual Education Program? *

Has your child ever been suspended? *

If yes, please explain

SECTION B STUDENT' S EMERGENCY INFORMATION (03)

Child’s Health Card *

Doctor's Name *

Doctor's Phone *

Does your child have allergies? *

If Yes, does your child have an EpiPen?

Is EpiPen submitted to the office?

List of Allergies

Does your child take any medication regularly? *

If yes, name, dosage and reason for the medication

Does your child have any Dietary Restrictions? *

Dietary Restriction (if any)

Layout (copy)

(4) Do you have more children attending Al Falah?

Add Another Student
Do Not Add Student

SECTION A STUDENT INFORMATION (04)

Student Type (04) *

Name *

First

Last

Date of Birth *//

Gender *

Male
Female

Grade (of student 4) in September *

Resource fee & entrance fee per student is added

Grade (of student 4) in September *

*Including Annual Supply & Evaluation Test fee per student

Other Fee(s)
* Admission fee per new student $250

** Supply fee per student $350

*** Evaluation test fee applies to new students only for Grades 1-8 $150

Other Fee(s)
Supply fee per student $350

Monthly Tuition Fee
* 10% discount will be applied by the school to the lowest monthly tuition fee(s)

Montessori Program Casa [Junior (4 year old) and Senior (5 year old)] Monthly Tuition & Fee is $735.00

Monthly Tuition & Fee for Grade 1-8 is $650.00

* Monthly tuition is deducted for 10 months

INCLUDES: Workbooks, photocopied materials, art supplies (paint, paint brushes, pastel paint, and construction paper), Montessori supplies, Chromebooks, STEM and coding program.

DOES NOT INCLUDE: Stationery, notebooks, duo tangs, folders, binders, and tissue boxes.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

First Language Spoken at Home *

Country of Birth *

Entry Date to Canada

(Only if birth country is not Canada)

Child Lives With *

Both parents
Mother
Father
Guardian

Upload Copy of Custody/Guardian Papers

Click or drag a file to this area to upload.

Name of Current School *

School Phone

Has your child ever been on Individual Education Program? *

Has your child ever been suspended? *

If yes, please explain

SECTION B STUDENT' S EMERGENCY INFORMATION (04)

Child’s Health Card: *

Doctor's Name: *

Doctor's Phone *

Does your child have allergies? *

If Yes, does your child have an EpiPen?

List of Allergies

Does your child take any medication regularly? *

If yes, name, dosage and reason for the medication

Does your child have any Dietary Restrictions? *

Dietary Restriction (if any)

Layout

SECTION C GENERAL DISCLAIMER

Assumption of Risk Islamic Circle of North America (“ICNA”), along with its affiliates, Al-Falah Islamic School ("AFIS"), cannot guarantee the absence of exposure to COVID-19 and/or any mutation or variation, despite implementing health and safety measures. By opting for in-person instruction at AFIS, parents acknowledge the risk of exposure to COVID-19 and/or its variations. Such exposure may occur directly or indirectly, regardless of the use of masks, gloves, or other personal protective equipment (PPE). Parents and guardians accept all risks associated with their child(ren) receiving in-person instruction at AFIS, including illness, bodily injury, permanent disability, and/or death related to exposure to COVID-19 and/or its variations.

Waiver and Release I/We hereby release, forever discharge, and hold harmless AFIS, its employees, and its agents from all liabilities, claims, and demands of any kind or nature, whether in law or in equity, that arise or may hereafter arise from my child’s return to school and/or participation in daily routines at the school.

The School Year Please note that throughout this form, any reference to the ‘School Year’ pertains to the academic year 2024/2025.

Please click on this if you agree with the agreement. *

I/We understand that this release discharges AFIS from any liability or claim that I/we may have against the school with respect to any bodily injury, personal injury, illness, or other issue that may result from my child’s return and/or participation in daily school activities or field trips/sports, whether caused by the negligence of the school, its directors, employees, or other agents, or by the negligence of others, or by the condition of the facilities or areas where school’s activities are being conducted.

SECTION D CODE OF CONDUCT

Please click to Read Code Of Conduct

Please click on this if you agree with the agreement. *

I/We have read and understood the aforementioned Code of Conduct and agree to abide by it.

FINANCIAL FORM

SECTION E: PARENT/GUARDIAN INFORMATION

Guardian Contact (01) *

First

Last

Email *

Occupation

Cell Phone *

Work Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Relation To Student

Guardian Contact (02) *

First

Last

Email *

Occupation

Address (if different from above)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Cell Phone *

Work Phone

Relation To Student

Are you or your spouse a current AFIS teacher, staff or board member? *

SECTION F: FEES

I/We, the undersigned, agree to abide by the conditions set forth regarding the Admission Fee (for new students), Resource Fee, Tuition Fee, and student withdrawal conditions. I/We hereby authorize AFIS to withdraw the designated tuition fee amount from our bank account on the 22nd of each month (over a 10-month period). Additionally, I/We authorize AFIS to charge the applicable Resource Fee in February of the School Year. *

I/We, the undersigned, agree to abide by the conditions set forth regarding the Admission Fee (for new students), Resource Fee, Tuition Fee, and student withdrawal conditions. I/We hereby authorize AFIS to withdraw the designated tuition fee amount from our bank account on the 22nd of each month (over a 10-month period). Additionally, I/We authorize AFIS to charge the applicable Resource Fee in February of the School Year.

Total Fee

$ 0.00

This total includes the Annual Resource Fee and Admission Fee (applicable to new students only). It will be withdrawn along with the first month's Tuition Fee for the next School Year. For the remaining months of the next School Year, AFIS will only withdraw the Monthly Tuition Fee.

SECTION G: MEDIA CONSENT

Please click to see Media Consent

Please click on this if you agree with the agreement. *

I/we understand and DO NOT object to the use and/or disclosure of this information for the purposes outlined in the Media Consent Form.

SECTION H: FINANCIAL AGREEMENT POLICIES

1. I/we understand that Admission, Evaluation, Waitlist, and Resource Fees are Non-Refundable. *

Yes

2. I/we understand that the Resource Fee is payable with the Registration Fee for returning students and new students. *

Yes

3. I/we understand that the Resource fee and Evaluation fee are payable with the Registration fee for new students in Grades 1 to 8. *

Yes

4. I/we understand that the registration will be considered incomplete, and a spot for my child is not guaranteed until *

Yes

• All arrears and outstanding payments are cleared.
• All completed registration forms are submitted to the office.
• Admission Fee is paid.
• All forms are signed by the parents/guardian.

5. I/we understand that tuition fees must be paid through 10 pre-authorized electronic withdrawals made on the 22nd of each month from August to May of the School Year. *

Yes

6. I/we understand that AFIS has our permission to withdraw the monthly tuition fee from my/our bank account from August to May of the School Year. *

Yes

7. I/we understand that if the attempt to withdraw the tuition fee is unsuccessful due to insufficient funds or incorrect banking info, a $35 charge will be incurred. *

Yes

8. I/we understand that if the fee is not paid by the 22nd of each month, a $35 late fee will be charged for every month it is delayed. *

Yes

9. I/we understand that after 30 days of NSF/Non-Payment of Fees, my child will not be allowed in the class. In this case, the school reserves the right to cancel the admission altogether. The re-admission of the same student, if applicable, will then be considered as a new admission subject to the availability of space. *

Yes

10. I/we understand that to withdraw my child(ren) from AFIS, a 60-day written notice/student withdrawal form must be given to the office. The parent or guardian is responsible for the tuition fee during the 60-day period. *

Yes

11. I/we understand that it is our responsibility to pay the full tuition fee during the entire withdrawal period of 10 months from August to May of the School Year. *

Yes

12. I/we understand that all textbooks given to my child(ren) must be returned in good condition; otherwise, a charge of $100 per textbook will be incurred. *

Yes

13. I/we understand that all tuition fees must be paid in full, regardless of travel, absenteeism, severe weather conditions, mode of instruction (online, in-person), or any other unplanned circumstances beyond the school’s control. *

Yes

14. I/we understand that all new students in Grades 1 to 8 will be tested for English and Mathematics before starting school, and they may be refused acceptance based on the results. *

Yes

15. I/we understand that all new Casa students will have a pre-assessment interview before starting school, and they may be refused acceptance based on the results. *

Yes

16. I/we understand that it is essential to pick up my/our child(ren) promptly at the designated dismissal time (3:30 PM - 3:45 PM). In the event of a late pick-up, a fee will be charged beyond the scheduled pick-up time as per the AFIS Late Drop Off or Late Pick-up Policy. *

Yes

17. I/we understand that it is essential to drop off my/our child(ren) promptly at the drop-off time (8:30 AM - 9:00 AM). In the event of a late drop-off, a fee will be charged as per the AFIS Late Drop Off or Late Pick-up Policy. *

Yes

SECTION I BANKING INFORMATION

Transit Number *

Maximum 5 digits

Institution Number *

Maximum 3 digits

Account Number *

Maximum 15 digits

Please attach the new PAD/VOID cheque to this form. *

Click or drag a file to this area to upload.

SECTION J SIGNATURE

Father's Signature *

Mother's Signature *

Guardian's Signature *

Admission Form 2024-25

REGISTRATION FORM

SECTION A STUDENT INFORMATION (01)

SECTION B STUDENT' S EMERGENCY INFORMATION (01)

SECTION A STUDENT INFORMATION (02)

SECTION B STUDENT' S EMERGENCY INFORMATION (02)

SECTION A STUDENT INFORMATION (03)

SECTION B STUDENT' S EMERGENCY INFORMATION (03)

SECTION A STUDENT INFORMATION (04)

SECTION B STUDENT' S EMERGENCY INFORMATION (04)

SECTION C GENERAL DISCLAIMER

SECTION D CODE OF CONDUCT

FINANCIAL FORM

SECTION E: PARENT/GUARDIAN INFORMATION

SECTION F: FEES

SECTION G: MEDIA CONSENT

SECTION H: FINANCIAL AGREEMENT POLICIES

SECTION I BANKING INFORMATION

SECTION J SIGNATURE

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LET’S NURTURE THE SEEDS OF TODAY INTO THE LEADERS OF TOMORROW!