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socialIQRA ISLAMIC SCHOOL

“Certified by the Ministry of Education, BC, Canada”

Application for Admission

Current Date (mm/dd/yy):

Session:

Student Information

Date of Birth (mm/dd/yy):

Place:

Gender:

Canadian /Landed Immigrant?

Immigration Authorization Expiry Date (mm/dd/yy):

Name & grade of any brother/s or sister/s attending (or will attend) IQRA Islamic School:

Name:

Grade:

Mother's Contact Information

Father's Contact Information

Guardian's Contact Information

Emergency contact (Not the name of the father/mother or the guardian)

General Information

Medical Information

Current Date (mm/dd/yy):

Session:

Student Information

Date of Birth (mm/dd/yy):

Place:

Gender:

Canadian /Landed Immigrant?

Immigration Authorization Expiry Date (mm/dd/yy):

Name & grade of any brother/s or sister/s attending (or will attend) IQRA Islamic School:

Name:

Grade:

Mother's Contact Information

Father's Contact Information

Guardian's Contact Information

Emergency contact (Not the name of the father/mother or the guardian)

General Information

Medical Information