Pearland Islamic Center (ISGH)Pearland Islamic Center (ISGH) logo

SUNDAY SCHOOL APPLICATION FORM 

Additional documents are required to complete the registration

Please bring in, email or fax this registration form

Student Information
            

    Gender

St. Address 1      St. Address 2

City     State      Zip

Name of School Now Attending     Current Grade

Entry Year     Class     Semester


Parents Information
Fathers First Name
  Middle Initial   Last Name   

Cell Phone
    Secondary Phone


Mothers First Name
  Middle Initial Last Name

Cell Phone
    Secondary Phone

Parent's Address
St. Address 1      St. Address 2

City     State      Zip

*



Physician & Medical Information
First Name
    Last Name

Primary Phone
    Secondary Phone

Practice/ Hospital


Physician's Address
St. Address 1      St. Address 2

City     State      Zip

Shots up to date? Yes No  Not Sure Not Applicable

Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns
 



Emergency Contacts
Contact 1
First Name
    Last Name      Relationship

Cell Phone
    Secondary Phone


Contact 2
First Name
    Last Name      Relationship

Cell Phone
    Secondary Phone



In submitting this information I hereby testify that it is true to the best of my knowledge. I understand that I am financially responsible for any balance owed with regards to the curriculum/ teaching/ supplies to Pearland Islamic Center - (ISGH).

Fees: $250 per semester / per kid (lunch included). Plus $30 one time book/supply fee.