The following forms must be completed before your application file will be considered, they can be submitted online below or downloaded and printed out via the links provided:

Please complete each item carefully

SECTION A

Must complete for each child

    Student Information

    Must Complete For Each Child

    Gender

    Date Of Birth

    Parent/Guardian Detail





    Emergency Contact Information
















    Home Address






    Health Information

    List health conditions, such as heart disease, diabetes, seizures, asthma, severe food or drug allergies, eye/ear problems, chronic illness, etc. and any medications the student takes:

    Please attach a copy of following documents with the application:

    Proof of residency

    Birth certificate

    Immunization records

    Report card for previous school year

    I Hereby



    In the event my child becomes ill or is injured at school and I cannot be reached, DarulArqam is authorized to contact the person(s) listed above, or take my child to the physician indicated, or to a hospital and is given consent for emergency care depending on the severity of the illness or injury. The Academy is NOT financially responsible for any emergency care and/or transportation. Signature below signifies compliance with all Academy policies and procedures

    PLEASE COMPLETE


    I UNDERSTAND AND AGREE TO THE DARULARQAM ADMISSION PROCESS.


    Parent/Guardian Consent:

    1. All the information I have provided in the Darul Arqam Center of Excellence Registration Form is true and correct to the best of my knowledge.
    2. I agree to pay tuition and other fee per payment by 5th of every month.
    3. I will be responsible for any damage caused to Darul Arqam property by my child and will compensate or replace the damage with an equal value and quality.
    4. I agree to follow and respect the Darul Arqam rules and regulations and explain them to my child who attends the Darul Arqam. I understand that I am responsible for disciplining my child in case of violation of any Darul Arqam rules, in conduct and/or academics. I understand that if any problem occurs, I will completely and fully accept the decision of Darul Arqam Administration.
    5. I give Darul Arqam Administration the authority to take necessary decisions to ensure my child safety and well-being when in their care. I give my child permission to participate in all activities deemed appropriate by Darul Arqam
    6. I understand my child will be taken on field trips with my written consent.
    7. I understand that the school will take any necessary action during an emergency.
    8. I indemnify Darul Arqam from any legal liability whatsoever.

    Terms and Conditions:

    I hereby authorize Darul Arqam Center of Excellence to initiate debit entries to the checking/savings account indicated above at the Financial Institution named, in the amount of the payment due and to make the deduction payable to Darul Arqam Center of Excellence. A record of each ACH transaction will be included in my regular bank statement and will serve as my receipt. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U. S. law. Any returned ACH payments will be charged a $25 service fee, which will be billed to you on your students’ monthly incidental billing.
    This payment plan is to remain in effect until the payment plan ends or is cancelled by the participant in writing within at least five business days before the next scheduled withdrawal date. The participant may terminate the agreement at any time by submitting written notice to the Darul Arqam Center of Excellence Business Office. Termination from the agreement on the family’s part will not release the family of any financial obligation to the school. Questions or concerns regarding any of these terms and conditions should be directed to the Office at 612-758-0501.