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New Student
Registration Form
Application process
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-
Step
1
of 5
Application Year
Which school year are you applying for?
*
Current Year (2025-2026)
Section A: Grade Classification
DropdownClass Applying For
*
Please Select
Junior Kindergarten (JK)
Senior Kindergarten (SK)
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Section B: Applicant’s Information
Name
*
First
Last
Date of Birth
Age
Gender
Please Select
Male
Female
Address
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Primary Phone Number
Secondary Phone Number
Email Address
*
Next
Section D: Parent's/Guardian's Information
Parent 1:
Name
*
Relationship
Father
Mother
Guardian
Phone
Email
*
Parent 2:
Name
*
Relationship
Father
Mother
Guardian
Phone
Email
*
Student Lives With
Both Parents
Father Only
Mother Only
Guardian
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Next
Section E: Emergency Contact Information
Doctor Contact
Emergency Contact Name 1
Name
*
First
Last
Relation with the Student
Cell Phone
Emergency Contact Name 2
Name
*
First
Last
Relation with the Student
Cell Phone
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Next
Section F: School Directory
I authorize Greenhill Islamic School to include the names, email addresses and other contact information for our immediate family in the school directory from the new student application form.
Section G: Medical Information
Health Card Number
*
Version Number
*
Name of The Family Doctor
Name
*
First
Last
Family Doctor Phone Number
Is Student's Immunization Record Complete?
Yes
No
Please list all medical conditions that may impact student's study at Greenhill Islamic School or that may require attention while you are on campus. If there are none, please enter N/A.
In case of emergency, I hereby give permission to the physician selected by the school or transport my child to a nearby emergency medical facility to provide necessary treatment for my child
I understand that minor injuries or accidents will be treated on the school premises and that I will be notified of any such treatment
I agree to inform Greenhill Islamic School immediately of communicable illnesses any of my family members contract even if they do not attend Greenhill Islamic School I agree to inform Greenhill Islamic School immediately of communicable illnesses any of my family members contract even if they do not attend Greenhill Islamic School
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Next
Section H: Financial Contract
Payment
1 -Payment Date: 1st of each Month. No other payment dates will be considered
2 -Leave: Any student who takes a leave of absence from school for any length of time during the academic year must pay full fees for that period
Refunds
1 -NO REFUND of Tuition Fee for the semester and Supply Fee in case student chooses to withdraw their names from the school for any given reason. (WITHDRAWAL FORM can be obtained at the Administration Office)
2 -NO REFUND of Tuition Fee for the semester and Supply Fee in case if student is found in violation of school regulations and asked to withdraw from the school
3 -NO REFUND will be made case of holidays, absences or if classes are cancelled due to the calamities (e.g.: Weather)
Fee Structure Academic Year 2025 / 2026
Direct Deposit Information
Branch/Transit Number
Institution Number
Account Number
I hereby authorize Greenhill Islamic School to initiate automatic deposits to my account at the financial institution named above. I also authorize Greenhill Islamic School to make withdrawals from this account in the event that a credit entry is made in error. Further, I agree not to hold Greenhill Islamic School responsible for any delay or loss of funds due to incorrect or incomplete information supplied by me or by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement will remain in effect until Greenhill Islamic School receives a written notice of cancellation from me or my financial institution, or until I submit a new direct deposit form to Greenhill Islamic School .
Submit
