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| *Student First Name: |
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*Student Last Name: |
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| *Date of Birth: |
MM/DD/YYYY |
Gender: |
MaleFemale |
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| Languages other than English spoken at home
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| Sibling/s attending this school
YesNo |
Is this a gifted child according to his/her school?
YesNo |
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| *Parents First Name: |
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*Parents Last Name: |
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| Address: |
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City, State and Zip: |
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| *Phone #: |
(999) 999-9999 |
Work Phone #: |
(999) 999-9999 |
| Cell Phone #: |
(999) 999-9999 |
Fax #: |
(999) 999-9999 |
| *Email Address: |
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Alternate Email: |
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| Please check the appropriate ethnicity |
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African
Asian
Latino
European/Caucasian
Native
Africa
Sub Continent
Middle East
Other:
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| Please tell us about the existing knowledge level of this child. check appropriate boxes |
| Arabic |
Recognizes some letters
Remembers most letters and write some letters
Write All letters
Can Join letters and make words
Knows Tashkeelaat (Fatha, Kasra, Shaddah, Maddah...)
Reads an ayah on his/her own
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| Islamic Studies |
They know simple manners (greeting, supplication for sneezing)
Some components of wudu and prayers
Pillars of Islam and Articles of Faith
Some stories of Seerah and Sahabah Biographies
Some stories from Quran and Hadith
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| Quran |
Have memorized one short surah
Have memorized six Ayahs
Have memorized 2/3 short Surahs
Have memorized one long Surah
Have memorized 3/5 long Surahs
Have memorized one Juz
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| Dear Parents: Please sign up for following any or all of 6 activity days to help us out |
| Field Trip 1 (Late June) |
Field Trip 2 (Mid July) |
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Presentation Day: Saturday July 28th 2007 (10 AM - 12 PM) |
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Any Important Notes you want to share (Optional):
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| Before you press the button below, please make sure all the important fields marked blue * are filled. |
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| Send your questions here |