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Application

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:

  1. Registration_Form.pdf
  2. Parental_Authorization_and_Release.pdf
  3. Home_Language_Survey.pdf
  4. Previous_school_record_request.pdf

If you are completing your application online, PLEASE NOTE your application will NOT be considered complete without all of the required documents listed in our Admissions_Process.pdf. After submitting your application online, you can email electronic copies of these documents to admissions@myiqa.org, mail them to ATTN: Application Documents, IQA, 840 Abrams Rd, Richardson, TX 75081, or deliver them in person to the IQA front office. Please include applicant's name and contact information on each document.

The non-refundable application & assessment fees of $150 can be paid online by following the Pay Tuition link (credit card charges apply), mailed in at above address, or paid in person to the IQA front office.

Registration Form

For Academic Year 2013-2014

Please note: Any false information provided on this form will nullify the student’s admission. Students requiring Special, Alternative, or ESL Education will not be admitted.

Last School Attended:
School Address:
School Phone:
Grade Last Attended:
City:
School Fax:
State:
Zip:

Names of Brothers/Sisters attending IQA

Name:
Name:
Grade:
Grade:

Please complete each item carefully

SECTION A:

Must complete for each child

Student's Name:
Current Level:
Gender:
Birth Date:
Birth Place:
Student's Social Security #:
Home Language:


Student's Name:
Current Level:
Gender:
Birth Date:
Birth Place:
Student's Social Security #:
Home Language:


Student's Name:
Current Level:
Gender:
Birth Date:
Birth Place:
Student's Social Security #:
Home Language:


Student's Name:
Current Level:
Gender:
Birth Date:
Birth Place:
Student's Social Security #:
Home Language:


Student's Name:
Current Level:
Gender:
Birth Date:
Birth Place:
Student's Social Security #:
Home Language:
SECTION B:

Completing for one child can suffice for others
The following information is exactly SAME AS mentioned on the application of my following child:

Ethnicity:

Father/Guardian Details
Legal Name:
Business Telephone:
Mobile:
 
Place of Employment:
E-mail Address:
Skills Father
can volunteer to IQA:
Mother/Guardian Details
Legal Name:
Business Telephone:
Mobile:
 
Place of Employment:
E-mail Address:
Skills Mother
can volunteer to IQA:

Home Address

Street:
Apt#:
City:
State:
Zip code:
Home Telephone Number:

My child may be released to the following person(s) only (Student will NOT be released to any other person without written authorization)

Name: Relationship to Student: Phone:

SECTION C: Must complete for each child

The information below applies to the following child(ren):

Local Doctor(s)

Name: Phone: Address:

My child has health insurance:

Health Insurance Provider's Name and Contact Information:

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:

I herby

In the event my child becomes ill or is injured at school and I cannot be reached, IANT Quranic Academy 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 IQA admission process.

Prospective Student Name: