salam foundation, islamic school...wishing to enroll in hifz–ul-quran. salam academy participates...

Salam Academy recruits and admits students of any race, color gender or ethnic origin to all its rights, privileges, and activities. In addition, the school will

not discriminate on the basis of race, color, gender or ethnic origin in the administration of its educational programs and athletics extracurricular activities.

The school will not discriminate on the basis of race, color, gender or ethnic origin in the hiring of its certified or non-certified personnel.

1515 Blake Dr. Richardson, TX 75081, www.Salamfoundation.us Phone: 972-480-0008

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Enrollment Form of 11

In the name of Allah the Most Merciful and the Most Beneficent.

"A father gives his child nothing better than a good education (intellectual and moral)"- Tirmidhi

We know that you have a choice in selecting the right school for your beloved children. Thank you and Congratulations on choosing Salam Academy for your child. This registration package has been carefully designed to acquaint you with our school and includes information to assist you as you carefully consider the educational opportunities available for your children. The pursuit of quality education for your child is an obligation. The choice of an Islamic school is an important one. At Salam Academy, our constant endeavor is to offer opportunities for each student to grow academically, spiritually, socially and physically. We at Salam Academy work very hard to achieve these great goals. Salam Academy follows the State of TX TEKS curriculum for Math English, Science, Social Studies, Technology, and other contemporary subjects. Being an Islamic School we have additional subjects on Islamic Studies, Quran, Arabic with a lot of emphasis on Tarbiah. This balance of contemporary school education in tandem with Islamic Education for a reasonable cost makes Salam Academy a unique and the only Islamic Magnet School nationwide till this day offering such services in USA.

The progress of our students is a continuous source of pride for us as we see them performing very well compared to other students locally, statewide, and nationally. Alhamdu-Lillah. For the past several years all our students passed Texas TAKS/STAAR tests making Salam Academy an Exemplary School. Alhamdulillah our students also take the National CTBS tests and the results speak about the quality of our education.

This academic year, we continue to focus on enriching and diversifying the curriculum offerings. We will achieve this by reinforcing our regular curriculum with a wide array of extra school activities to stimulate learning and discovery.

We have moved to a new, bigger and better facility and will be upgrading our infrastructure includingbut not limited to state of art Science labs, expanding the current computer lab, addition of high techteaching aids, etc.

We already have an option for Hifz program integrated in our syllabus for students and parentswishing to enroll in Hifz–Ul-Quran.

Salam Academy participates in Science Fair, Spelling Bee, Geography Bee, PSIA, Quran and IslamicEducation Contests. These contests can be Local, County, State, and/or National Level.

We now prepare our students for the High School Collegiate and Dual Credit program incollaboration with Richland Community College.

Our well trained dedicated team welcomes you and your child (ren) to Current Academic year at Salam Academy. We hope this will the best experience for you and your family Inshallah! Please call the school office with any questions you may have about the admission process. You may also email us at: [email protected]

With Best Regards Administration

Assalamu-Alaikum Dear Parents,

SALAM ACADEMY FAITH CHARACTER & EXCELLENCE IN EDUCATION

A Full time Islamic Magnet School PreK-High School1515 Blake Dr. Richardson, TX 75081

Ph: 972-480-0008, 972-704-4373 www.salamfoundation.us





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Fee Schedule for 2014 -2015

***Pre-School fees and application is separate.

(A LATE FEE OF $25 WILL APPLY AFTER THE 5TH OF EACH MONTH)

*Extended after care is available until 6 PM for an additional fee of $100/month, regardless of # of

days your child attended school.

If a payment is not received by the 10th of the month, the student may not attend school until payment is received.

Your child will be dismissed if a payment is not received by the 1st of the following month. There will be a $25

charge for any returned check. Tuition installment is due in full regardless of the number of days your child has attended school. You are responsible of making payment regardless of number of months your child attended school (10 installments).

“And fulfill (every) engagement, for (every) engagement will be inquired into (On the Day of Reckoning)” Surat Al-Israa verse 34

NOTE: For your application to be accepted, all Registration, Books and Materials Fees must be submitted with the application. The Registration Fee is non-refundable.

I agree and commit to making timely prompt payments as stipulated in this fee schedule.

__________________________________ _________________ Signature of parent Date

ONE-TIME FEES PER CHILD Registration Tuition

Registration Processing Fee $150

$2000 / Year Books & Materials Fee $350

PERIODIC FEES SCHEDULE – $200/Month for Ten (10) Months due 1st of each month

1st payment due by August 1st ,2014








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ENROLLMENT FORM FOR 2014 – 2015

Grade Applying For: ____________________

IMPORTANT DATES (Please complete all information) Early Registration Starts : March 21st – April 30th 2014

Financial Assistance Application Deadline : July 16th 2014

OFFICE USE ONLY

Account # _______________ Application Date: __ ___ Admission Date: __________

Withdrawal Date: _________________ All dues paid Turn-in all books/library books/materials

Registration Fee: ______________ Auto Withdrawal Card Cash

Books/Material Fee: ____________ Auto Withdrawal Card Cash

Enrollment Checklist: Application Checked Enrollment Contract Parent Acknowledgement Birth Certificate Immunization

Record Emergency Card Previous School Record

Placement Test Date: _________________ by: ________________________________________

Comments: _______________________________________________________________________

PERSONAL INFORMATION

1. Child’s Name ____________________________________________________________________________ (Last Name) (First Name)

2. Date of Birth : Male Female

(Middle)

SSN :

3. Home Address : _________________________________________________________________________ (Street) (City) (State) (Zip Code)

Home Phone ______ _____ Race/Ethnic origin -_________________

4. Father’s Name :_____________________________ Work Phone: ________________________

E-mail : _______________________________ Occupation: ________________________

Home Address (If different from child’s address) : _____________________________________________

Employer Name and Address : ____________________________________________________________

Highest Education Completed : Doctoral Masters Bachelor High School

Marital Status : ___________________

5. Mother’s Name :_____________________________ Work Phone: _________________________

E-mail : ________________________________ Occupation: _________________________

Home Address (If different from child’s address) : _____________________________________________

Employer Name and Address : ____________________________________________________________

Highest Education Completed : Doctoral Masters Bachelor High School








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Marital Status : ___________________

Family income: ____________________ Weekly Bi-weekly Monthly Annually CONTACT INFORMATION AND RELEASE DIRECTIONS List ALL TelephoneNumbers where Parents / Guardian may be reached while child will be in school

Mother’s Telephone No. Father’s Telephone No. Guardian’s Telephone No.

In case of emergency, give name of person of to be contacted if parents / guardian cannot be reached at the above numbers

Name and Phone Number Relationship to Student

I hereby authorize Salam Academy to allow my child to leave the facility ONLY with the following persons (other than parents/guardian)



CURRENT AND PAST MEDICAL CONDITIONS List any special problems that your child may have such as allergies, existing illness, previous serious illness, injuries during the past 12 months, any medications prescribed for long term continuous use and any other information which our staff should be aware of :

_______________________________________________________________________________________

_______________________________________________________________________________________

OTHER INFORMATIONSalam Academy is strongly committed to meeting the needs of its students. In order to provide programs and resources to meet students' needs, Salam Academy seeks accurate and timely information from prospective families regarding the learning history of applicants for admission.

1. List the public school district in which your child resides:

2. List all previous schools attended (List most recent first):

Name of School: _____________________________ Grade : _______ Year : ______________

School Phone Number: _______________________

Address: ________________________________________________ ZIP Code: _____________

Name of School: _____________________________ Grade: _______ Year: ______________

School Phone Number: _______________________

Address: ________________________________________________ ZIP Code: _____________

Reason for leaving previous school (s) _________

3. Has the student ever repeated a grade? If yes, describe which grade and why.

4. Has the student ever been suspended, expelled, or received any disciplinary action in school? If yes, describe

which grade and why.

5. Does your child have any physical disabilities? If yes, please explain.

________________________________________________________________________________

___________________________________________________________________________________


1515 Blake Dr. Richardson, TX 75081Ph: 972-480-0008, 972-704-4373

www.salamfoundation.us





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6. Has your child been referred for (check one of the following):

Learning disabilities Language processing ADHD / ADD Emotional difficulties

7. Has your child been tested for (check one of the following):

Learning disabilities Language processing ADHD/ADD Emotional difficulties

Initial test date ________ Most recent test date _______ Please submit a copy of most recent test result.

8. If yes, please explain.___________________________________________________________________________________

9. List the subjects in which you believe your child excels -______________________________________

10. List the subjects which you believe are difficult for your child-__________________________________

11. List any extracurricular school activities your child has participated in during the last school year, ex. clubs,

Masjid activities, sports, or special programs- _________________________________________________

12. The student lives with :

Both Parents Father Mother Other _________________________________ Please give name, school and grade siblings are attending _______________________________________ ___________________________________________

_______________________________________ ___________________________________________

13. Please share your reasons for applying to Salam Academy ____________________________

______________________________________________________________________________________

AUTHORIZATION FOR EMERGENCY MEDICAL ATTENTIONIn the event that I cannot be reached to make arrangements for emergency medical attention, I authorize Salam Academy’s Director or person in charge to take my child to :

To the Nearest Hospital / medical facility OR

Name of Physician : Address : Phone Number :

Name of Hospital : Address : Phone Number :

I give consent for Salam Academy to secure any and all necessary medical care for my child. I absolve Salam Academy from liability to my child because of injury in the school, field trip or other school activity away from school. I further understand that Salam Academy will not be responsible for any charges / expenses incurred as a result of emergency/urgent / first aid medical attention provided to my child. I bear full responsibility for expenses of this nature.

X___________________________________

Signature of Parent / Guardian








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To the best of my ability, I/we have provided accurate and truthful information on this application for admission. I understand and agree that the admissions process cannot be completed until Salam Academy has received all required documents. I understand that incorrect and incomplete information and late or non-payment of fees and /or tuition may result in delays and possible declination of admission. I understand that all

registration fees are non-refundable.

All new students are on probation for the first three months.

Parent/Guardian’s Signature: _______________________ Date: ____________________

Name: _________________________ Relationship to Student: __________________

CONSENT & ACKNOWLEDGEMENTS TRANSPORTATION I hereby give do not give my consent for my child to be transported and

supervised by the school staff on field trips

WALKING HOME I hereby give do not give my consent for my child to be allowed to walk home or to be released to the care of the named sibling ____________________________ who is under the age of 18 years

WATER ACTIVITIES I hereby give do not give my consent for my child to participate in water activities

sprinklers splashing pools swimming pools other bodies of water

FIELD TRIPS I hereby give do not give my consent for my child to participate in field trips.

PARENT COMMENTS _____________________________________________________________________________

ACKNOWLEDGEMENTSI acknowledge receipt of “A Parent’s Guide to Salam Academy”. I further understand that the school policies and procedures are available for review at the school office.

X___________________________________

Signature of Parent / Guardian








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Automatic Payment Form 2014 – 2015

*Student’s Name: *Grade:

Grade:

Grade:

Grade:

*Parent/Guardian/Sponsor Name:

*Phone: Home Work

*E-Mail:

*Total Amount (Tuition Fees/Books, etc.): *Monthly Amount:

X Signature: Date:

I give permission to Salam Academy to withdraw tuition fees and other charges related to the above

student(s) from my account each month. I will submit written approval of changes or termination within

reasonable time to adjust the records accordingly.

---------------------------------------------------------------------------------------------------------------------

---------------------------------------------------------------------------------------------------------------------

Credit Card Payment:

*Card#:

*Expiration Date: / / CVV Code:___________________

*Name (as it appears on the card):

*Billing Address: ___

*Phone number:____________________ *E-Mail Address:_____________________________

* Fields marked with an * must be filled out.

**








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ENROLLMENT AGREEMENT (2014 – 2015) (Note: Complete only one for all children)

Name of Student : ____________________________________________________ Grade : _________




I hereby place my confidence in the ability of the administration and staff of Salam Academy to perform the

educational function due to my child (ren) at their discretion.

I agree to accept all regulations of the school on the applicant's behalf and authorize Salam Academy to employ such discipline, as it deems wise and expedient for my child (ren). I realize that occasionally children

may make an issue with actions that they do not agree with and that they are prone to take teacher criticisms out of context. I pledge that if this should occur, I will seek to clarify the matter with the teacher and / or Principal first. If necessary, I will correct my child (ren) and will support the school personnel. I will follow the same procedure for any school incidents that may occur.

I pledge to build a strong relation with my child(ren)'s teachers and aid in the training of my child(ren) by providing an Islamic example at home, supporting the spiritual training of the school, following through with any work assignments or slips to be signed, ensuring that my child(ren) arrive(s) at school on time, sending in written excuses for absences or tardiness, teaching my child(ren) to respect school property, and attending all events/meetings for parents.

As stated in the authorization section of the enrollment form, in the event my child (ren) become(s) ill or is injured at school and I cannot be reached, Salam Academy is authorized to contact the person(s) listed in the

application form, or to transport my child (ren) to the nearest hospital and is given consent for emergency care depending on the severity of the illness or injury. I absolve Salam Academy from liability to my child because of injury in the school, field trip or other school activity away from school. The school is NOT financially

responsible for any emergency care/hospital expenses or transportation. I understand that a large part of Salam Academy operations are sustained by charitable donations, and for fundraising and other promotional purposes. Salam Academy may conduct video, still photography, display of student work and live performances throughout the academic year. I agree that unless I submit a written statement to the contrary, Salam

Academy has my consent and support to include my child (ren) in such promotional activity.

Unless otherwise stated in the enrollment form, I give permission for my child (ren) to take part in all school activities, including sports and school sponsored field trips away from or on the school premises. I understand that the school policies are available for review on request at the school office. I agree to comply with school policies and procedures as may be amended from time to time.

Tuition and Other Dues: I agree and commit to make prompt payments as stipulated in the attached “FeesSchedule” with applicable penalties for late payments. I further understand that my child (ren) may not be allowed to attend class due to delinquent payments at the discretion of the school administration.

All new students are on probation for first three months.

______________________________________ __________________

Signature of the Parent / Guardian Date

“And fulfill (every) engagement, for (every) engagement will be inquired into (On the Day of Reckoning)” Surah Al-Israa verse 34








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Admission Requirements 2014 - 2015

Please read the following instructions carefully. They have been prepared to assist you in the application process. Parents will be notified of admission status once the admission process is complete.

IMPORTANT DATES

Early Registration Starts

: March 21st

-April 30th2014

Late Registration Fee After

: May 1st 2014

Registration Ends : August 13th 2014 Financial Assistance Application Deadline

: July 16th

2014

The following requirements apply to new applicants:

Enrollment Form: Duly completed and signed enrollment forms with all supporting documents

must be submitted. Incomplete or inaccurate applications may result in delay and possible loss

of admission.

Application Packet Checklist:

Enrollment Form Enrollment Agreement Consent for

Transfer of School

Records (new students)

Emergency Medical

Authorization

Discipline and Guidance Policy

Acknowledgement

Supporting Documents Checklist:

Birth Certificate copy Immunization Record Previous report cards

Vision & Hearing Test Report Past Referrals for disciplinary action,

counseling, suspension, expulsion, etc.

For Early Childhood and Kindergarten only: others need to transfer from previous school

Health Requirements

Form

Vision & Hearing Test

Report

Tuberculosis Test Report

(if required by district)








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Fees and Tuition: All Fees and Tuition must be paid as stipulated in the Fee Schedule. Theregistration and tuition Fee is non-refundable.

Once the child is in school, no refunds or cancellations of tuition and / or other fees will be

made regardless of subsequent absences, withdrawal or dismissal of the student from the

school.

Transfer Records: Transferring Students must have a satisfactory report and a letter of

recommendation from the previous school attended. A signed release letter for the student's

transfer record is required. (Please see attached form). A copy of the student’s standardized

exams for the past years and Individual Education Plan (IEP if applicable) must be attached to

the application.

Placement Test / Evaluation: Applicants for KG and up will undergo a placement test /

evaluation. Students enrolling in grades five and up must write a personal essay. Testing will be

conducted prior to the start of the academic year and parents will be notified in advance of the

dates of the placement test. Parents may call to schedule an appointment for the placement

test.

Early Childhood Applicants: At the discretion of the school, parents may be required to

attend an interview as part of the admission process.

Age Eligibility: Students must reach the minimum age eligibility by September 1st of the

academic year applied for. For example:

- Pre K students must be minimum three years for the 3 year level or four years of age by

9/01 of this year for the 4 year level.

- KG students must be five years of age by 9/01 of this year etc.

Eligibility for higher grades will be based on a combination of age, maturity, school records and

the placement test / evaluation.

Waiting List / Availability of Seats: Depending on the grade applied for, seats may or may

not be available, and the applicant may be placed on a waiting list. In this event, you will be

notified and given a waitlist rank based on the date your application was received. At this point

you may choose to withdraw your application but the registration fee will not be refunded.

Probation Period: New students are on probation for the first four months that they are

enrolled at school and may be dismissed from the school at any time for valid academic or

disciplinary reasons.

Special Education / ESL: Salam Academy currently does not provide special education / ESL

or alternative programs and as such will not be able to enroll students recommended for these

programs.

Financial Assistance: Salam Academy offers limited financial assistance (for tuition only) to

qualified applicants. A separate application is necessary and must be submitted prior to the

deadline for Financial Assistance Applications. If you feel you are eligible for financial assistance

please contact the office at 972-480-0008. Financial Assistance is funded primarily by the

Sadaqah/Zakaah and community members’ donations.

NOTE: Parents are responsible for keeping student information current (addresschange, phone number, immunization records etc).

FOR ALL QUESTIONS: Please call 972-480-0008








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Discipline and Guidance Policy

1. Discipline must be:1.1.1. Individualized and consistent for each child; 1.1.2. Appropriate to the child’s level of understanding; and 1.1.3. Directed toward teaching the child acceptable behavior and self-control.

2. A caregiver may only use positive methods of discipline and guidance that encourage self-esteem,self-control, and self-direction, which include at least the following:

2.1.1. Using praise and encouragement of good behavior instead of focusing only upon unacceptable behavior;

2.1.2. Reminding a child of behavior expectations daily by using clear, positive statements; 2.1.3. Redirecting behavior using positive statements; and 2.1.4. Using brief supervised separation or time out from the group, when appropriate for the

child’s age and development, which is limited to no more than one minute per year of the child’s age.

3. There must be no harsh, cruel, or unusual treatment of any child. The following types of disciplineand guidance are prohibited:

3.1.1. Corporal punishment or threats of corporal punishment; 3.1.2. Punishment associated with food, naps, or toilet training; 3.1.3. Pinching, shaking, or biting a child; 3.1.4. Hitting a child with a hand or instrument; 3.1.5. Putting anything in or on a child’s mouth; 3.1.6. Humiliating, ridiculing, rejecting, or yelling at a child; 3.1.7. Subjecting a child to harsh, abusive, or profane language; 3.1.8. Placing a child in a locked or dark room, bathroom, or closet with the door closed; and 3.1.9. Requiring a child to remain silent or inactive for inappropriately long periods of time for

the child’s age.

Academic & Behavioral Consequences:

In School- Time out Detention

Out of School- 1-3 day’s suspension

Termination Academic Performance 1st Term failed – Student will go on Academic Probation until next term. 2nd Term failed – Termination of the student from Salam Academy due toAcademic Performance.

My signature verifies I have read and received a copy of this discipline and guidance policy.

____________________________ __________________

Signature Date


