━ ADMISSION

Register Your Child at Ikhlas Academy

Complete the registration form below to begin your child’s enrollment at Ikhlas Academy. Please provide accurate information so our team can review the registration and contact you regarding class placement and next steps.

Student First Name*

Last name*

Date of Birth*

Age*

Gender*

Male

Female

Has the student attended an Islamic school before?**

Yes

No

Current School Grade*

Parent/Guardian Full Name*

Relationship to Student*

Phone Number*

Email*

Home Address*

Please Choose the Shift you Prefer

Morning Shift — 9:00 AM–1:00 PM

Afternoon Shift — 2:00 PM–6:00 PM

Emergency Contact Name*

Relationship to Student*

Emergency Phone Number*

Allergies or Medical Information

Anything else Ikhlas Academy should know about the student

Parent/Guardian Acknowledgment I confirm that the information provided in this registration form is accurate to the best of my knowledge. I understand that submitting this form does not guarantee enrollment and that Ikhlas Academy will contact me regarding registration status, class placement, and any additional requirements. I agree to follow Ikhlas Academy’s policies and procedures and will inform the school of any important changes to my child’s information.*

Yes

iKhlas Academy

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6875 HWY 65 NE
Fridley, MN 55432
Saturday & Sunday: 9:00 AM – 6:00 PM

info@ikhlasacademy.org

(763)296-5119

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