Student Application

A'Ala Yasir Educational Center

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Temporary Historical Student Entry

Temporary entry mode is active so the Center can enter students who originally enrolled when they were age 12 or under. The normal age-12-and-under registration rule will be restored after this historical data entry is completed.

Enrollment Availability Notice

Submitting an application does not guarantee immediate enrollment. If a class is full, your child may be placed on a waiting list. A'Ala Yasir Educational Center will contact you to let you know whether your child has been accepted, placed on the waiting list, or if additional information is needed.

Family Status

Are you a new family or an existing A'Ala Yasir family?*

Choose Existing A'Ala Yasir Family if you already have a child enrolled at the Center.

Family ID*

Enter your A'Ala Yasir Family ID. If you do not know it, please contact A'Ala Yasir Administration for help before submitting.

Student Information

First Name*

Middle Name

Last Name*

Date of Birth*

Gender

Requested Class*

Parents may request Qur’an or Hingaad; however, each student will be assessed and placed in the class that best matches their current learning level.

Parent / Guardian Information

Parent / Guardian 1

Full Name*

Relationship to Student

Phone Number*

Email Address

Parent / Guardian 2

Optional

Full Name

Relationship to Student

Phone Number

Email Address

Emergency Contact

Please provide someone the school can contact in an emergency if a parent or guardian cannot be reached.

Emergency Contact Full Name*

Relationship to Student*

Phone Number*

Alternate Phone Number

Email Address

Medical & Health Information

Does the student have any health conditions?*

Include any medical condition the school should know about.

Health Condition Details*

Does your child have any diagnosed or known developmental, learning, communication, behavioral, sensory, or medical support needs that require specialized services or accommodations?*

Examples may include autism spectrum disorder, significant speech or language delay, developmental delay, ADHD requiring specialized support, sensory support needs, intellectual disability, or other conditions requiring individualized assistance.

Important: A'Ala Yasir Educational Center is not a special education program and does not currently provide specialized special-needs services, one-to-one aides, therapy, or individualized clinical support. Please provide complete and accurate information so the Center can determine whether it can safely and appropriately meet the student's needs.

This application will require administrative review before enrollment can be approved.

Specialized Support / Accommodation Details*

Does the student have any allergies?*

Please include food, medication, environmental, or other allergies.

Allergy Details*

Does the student take any medications?*

Include any medication the school should know about.

Medication Details*

Additional Children

Optional. Finish the first student's information above. If you are applying for another child from the same family, click Add Another Child below. Each added child has their own class and medical information; parent and address information are shared.

Home Address

Street Address

Apt / Unit

City

State

ZIP Code

Additional Information

Previous School / Dugsi

Notes or Additional Information

Preferred School Communication Method*

Choose the main way you would like A'Ala Yasir Educational Center to contact you about school notices, attendance, payments, registration, and student-related information. If you checked the SMS consent box above, SMS / Text Message will be available. If you did not opt in to SMS, choose Email or Phone Call.

Preferred Method*

Parent Agreements & Authorizations

Attendance Policy

I acknowledge that consistent attendance and communication are required to maintain my child’s enrollment at A'Ala Yasir Educational Center. If my child is absent for two consecutive weeks without an excused absence and without communication from the parent or guardian, the student will be disenrolled from the Center. I understand that any future reenrollment will be subject to the Center’s policies, available space, and approval.

Vacation Policy

I acknowledge that any vacation or temporary leave of absence must be communicated to A'Ala Yasir Educational Center in advance. I understand that I remain responsible for all applicable tuition and fees during the absence if I wish to reserve and maintain my child’s place in the Dugsi.

Emergency Medical Authorization & Liability Acknowledgment

I certify that I have disclosed all known medical conditions, allergies, medications, developmental or learning needs, communication needs, sensory needs, behavioral support needs, diagnoses, or other information that may affect my child’s safety, learning, participation, or support at A'Ala Yasir Educational Center. I understand that providing complete information helps the Center determine whether it can safely and appropriately meet my child's needs. I also understand that the Center is not a special education program and does not provide specialized special-needs services, one-to-one aides, therapy, or individualized clinical support. In an accident, illness, or emergency, if the Center cannot reach a parent, guardian, or emergency contact, I authorize the Center to contact emergency medical services and, when reasonably necessary, arrange transportation to an appropriate medical facility. I understand that I am responsible for medical expenses related to such treatment.

Photo / Video Release

I authorize A'Ala Yasir Educational Center to photograph or record my child during school activities and to use those photographs or recordings for lawful school-related purposes, including the Center’s website, social media, printed materials, newsletters, and other promotional or educational communications. I understand that I may revoke this authorization for future use by providing written notice to the Center.

Photo / Video Permission*

Yes, I give permission.

No, I do not give permission.

Parent Certification & Agreement

I certify that the information provided in this application is complete and accurate. I acknowledge that I have read and agree to the applicable attendance, vacation, emergency medical, tuition/payment, and other school policies stated above.

Parent / Guardian Full Name*

I have read and agree to the Parent Agreements & Authorizations above.*

Submitting this application does not guarantee enrollment. Applications are reviewed by A'Ala Yasir Educational Center before admission is approved.