Al-Jeel Al-Jadeed Arabic School
Registration Form
School Year 201ϲ/201ϳ
Student Full Name: ………………………………………………………………………………………………………………………
Father's Name: …………………………………………………………………………………………………………………………….
Mother's Name: …………………………………………………………………………………………………………………………..
Place of Birth: ………………………………………………………..…. Date of Birth: ..…………………………………….
Address (St. # and name): ……………………………………………………………………………………………………………
City: ………………………………………………………………………….. Postal Code: ………………………………………..
Phone No. ‐ Home: ……………………………………..…………… Mobile: …………………………………………….….
Level of Education ‐ Grade: .…..……………………………….…
English School French School French Immersion School
Name of the School: …………………………………………………………………………………………………………………….
Arabic Language Knowledge:
Arabic Alphabet: Yes No Some
Arabic Numbers: Yes No Some
Language used (spoken) at home: English French Arabic
Health Information:
Any Allergies? Yes No Please state: …………………………………………………….
……………………………………………………………………………………………………………………………………………………..
Emergency Contact:
Name: ………………………………………………………………………………………………………………………………………….
Phone No.: ……………………………………… E-mail: ………………………………………………………………………..
‐ Please note that all information collected is solely for administration use and will not be shared
with other parties.
‐ Registration fee per school year is $100/Child (2nd sibling is $75; every additional sibling is $50).
‐ Classes will be held on SATURDAY (10:30 a.m. ‐ 1:00 p.m.) at ACCO Center at 1289 Matheson
Blvd. East, Missssauga, ON., L4W 1R1.
‐ This project is on voluntary basis for both staff and administration. The fees will cover the cost
of the rent and photocopying of educational materials.
Administration
