Re-Enrollment | San Francisco Islamic School

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Parents / Guardians Information
Father's (Guardian's)
First Last
Mother's (Guardian's)
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Occupation
Employer's Name
First Last
Work Phone*
Mobile Phone*
Custody Information
Who has legal custody?
- Both Parents
- Father only
- Mother only
- Others
Others*
Students lives with
- Both Parents
- Father only
- Mother only
- Others
Others*

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Health Information
Does your child require any special needs that we should know about?
- Yes
- No
This can include learning styles, individual academic needs, psychological or behavior difficulties, or physical limitations.
If yes, please explain below
(more details should be outlined in the Medical Release Form)
Does your have any food allergies that we should know about?
- Yes
- No
If yes, please explain below
(more details should be outlined in the Medical Release Form)
Child’s Primary Physician’s Name
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Insurance Provider

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Emergency Information
Medical Emergency Policy: Parents and emergency contacts will be called for injuries/illness beyond our ability to handle. “911” will be called to assist in the event of serious illness or injury. This emergency policy will be used for all students and your child’s attendance at this school represents your acceptance of this policy.
Emergency Contact #1 Name & Phone Number:*
Relationship to Student
Emergency Contact #2 Name & Phone Number:*
Relationship to Student
Authorized Pickup
List names of persons authorized to sign your child out of school. Identification will be required.
Name
First Last
Name
First Last
Name
First Last
Name
First Last
Release of Information Authorization
Listing of Home Address, Home phone Number and Email Address in the School Directory
- Yes, I want our Address, Phone Number and Email to be listed in the School Directory
- No, I do not want our Address, Phone Number and Email to be listed in the School Directory
Permission to take your Child’s Picture
- Yes, I have no objection in having my child’s picture taken or used in SFIS website and publications.
- No, I do not want my child’s picture taken.
Financial Aid
Should you require financial assistance please fill out the Financial Aid Form. Financial Aid information is handled in strict confidentiality. Please note that SFIS relies on students’ tuition to operate.

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Re-enrollment 2022-2023