ISLAMIC SCHOOL OF AUGUSTA

Registration Form

Class __________

Date of Registration

Student’s Name

(Last) (First) (Middle)

Address (Street Address)

City State Zip Code _______________

Phone Number ( ) - - - - - - -

Date of Birth _________________ Age at Registration _____________

The year student was first admitted to ISA

(If this is the first year, write NEW)

Father’s/Guardian’s Name

Occupation

Office Phone No

Mother’s Name

Occupation

Office Phone No

In case of emergency notify (other than parents)

Name Telephone No.

I received a copy of the rules and regulations of Islamic School of Augusta.

X ___________________

(Parent’s /Guardian’s Signature)

FEES PAID

Date paid Amount School Official’s initial