Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student Information Name *FirstMiddleLastGender *MaleFemaleDate of Birth *Place of Birth *Which grade are you applying for? *Montessori Pre-K 3Montessori Pre-K 4Montessori Kindergarten1st grade2nd grade3rd grade4th grade5th gradeCurrent School (if applicable)Reason for Leaving (if applicable):School District *District-assigned school *Please use the district's school locater or boundary map to identify your assigned school building based on your home addressStudent Primarily Lives With *Both ParentsMother OnlyFather OnlyMother and StepfatherFather and StepmotherOther RelativesLegal GuardianFoster ParentsOther (please specify)(please specify) *Is the Student’s Address the Same as the Parent/Guardian’s Address? *YesNoStudent's Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs the Student's Mailing Address Different from the Physical Address? *NoYesStudent's Mailing Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code(If different than place of resident, please provide the student's mailing address).Would you like to add sibling(s) to the application?NoYesHow many sibling(s) would you like to add to the application? Non-refundable application fee *How many sibling(s) would you like to add to the application?OneTwoThreeFourFiveName of Student 2 *FirstMiddleLastStudent 2 Gender *MaleFemaleStudent 2 Date of Birth *Student 2 Place of Birth *Which grade are you applying for? Student 2 *Montessori Pre-k 3Montessori Pre-k 4Montessori Kindergarten1st grade2nd grade3rd grade4th garde5th gradeCurrent School Student 2 (if applicable)Reason for Leaving Student 2 (if applicable):Name of Student 3 *FirstMiddleLastStudent 3 Gender *MaleFemaleStudent 3 Date of Birth *Student 3 Place of Birth *Which grade are you applying for? Student 3 *Montessori Pre-k 3Montessori Pre-k 4Montessori Kindergarten1st grade2nd grade3rd grade4th grade5th gradeCurrent School Student 3 (if applicable)Reason for Leaving Student 3 (if applicable): Name of Student 4 *FirstMiddleLastStudent 4 Gender *MaleFemaleStudent 4 Date of Birth *Student 4 Place of Birth *Which grade are you applying for? Student 4 *Montessori Pre-k 3Montessori Pre-k 4Montessori Kindergarten1st grade2nd grade3rd grade4th grade5th gradeCurrent School Student 4 (if applicable)Reason for Leaving Student 4 (if applicable): Name of Student 5 *FirstMiddleLastStudent 5 Gender *MaleFemaleStudent 5 Date of Birth *Student 5 Place of Birth *Which grade are you applying for? Student 5 *Montessori Pre-k 3Montessori Pre-k 4Montessori Kindergarten1st grade2nd grade3rd grade4th grade5th gradeCurrent School Student 5 (if applicable)Reason for Leaving Student 5 (if applicable): Name of Student 6 *FirstMiddleLastStudent 6 Gender *MaleFemaleStudent 6 Date of Birth *Student 6 Place of Birth *Which grade are you applying for? Student 6 *Montessori Pre-k 3Montessori Pre-k 4Montessori Kindergarten1st grade2nd grade3rd grade4th grade5th gradeCurrent School Student 6 (if applicable)Reason for Leaving Student 6 (if applicable):Parent/Guardian 1 Parent/Guardian Name 1 *FirstMiddleLastRelationship to Child *Parent/Guardian's 1 Phone *Parent/Guardian's 1 Email *Parent/Guardian's 1 Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOccupation(s) of Parent/Guardian 1: *Educational Background of Parent/Guardian 1: *High School Diploma or EquivalentAssociate DegreeBachelor's DegreeMaster's DegreeDoctorate DegreeProfessional DegreeOther (please specify)(please specify) *Parent/Guardian 2 Click here if Parent 2/ Guardian is not applicable (e.g. single parent)Click here if Parent 2/ Guardian is not applicable (e.g. single parent)Parent/Guardian Name 2 *FirstMiddleLastRelationship to Child *Parent/Guardian's 2 Phone *Parent/Guardian's 2 Email *Is the Parent/Guardian’s 2 Address the Same as the Parent/Guardian’s 1 Address? *YesNo (Please provide the address below)Parent/Guardian's 2 Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOccupation(s) of Parent/Guardian 2: *Educational Background of Parent/Guardian 2: *High School Diploma or EquivalentAssociate DegreeBachelor's DegreeMaster's DegreeDoctorate DegreeProfessional DegreeOther (please specify)(please specify) *Home Language Which language is spoken MOST in your home? *EnglishArabicUrduSpanishHindiFrenchChinese (Mandarin)RussianPortugueseGermanJapaneseKoreanItalianTurkishBengaliVietnamesePersian (Farsi)DutchGreekThaiSwahiliTamilTeluguMarathiKannadaGujaratiPunjabiMalayalamHebrewPolishUkrainianRomanianHungarianCzechSlovakBulgarianSerbianCroatianBosnianSwedishNorwegianDanishFinnishIcelandicFilipino (Tagalog)MalayIndonesianBurmeseKhmerLaoNepaliSinhalaPashtoAzerbaijaniUzbekKazakhArmenianGeorgianAlbanianMacedonianSlovenianEstonianLatvianLithuanianMalteseBasqueCatalanGalicianWelshIrishScottish GaelicBretonCorsicanLuxembourgishMalagasyHaitian CreoleYorubaZuluXhosaShonaSesothoTswanaAmharicSomaliTigrinyaHas your student received English as a Second Language (ESL) instruction? *YesNoReference We’d love to get to know your family better! Please share the contact information for one or two community members who can tell us more about your family’s educational values and character. This could be a teacher, mentor, or family friend. Please include their name, relationship to you, phone number, and email address. Name *FirstLastPhone *Name FirstLastPhone Additional InformationHow did you hear about Ohio Ihsan Academy? *Do you give Ohio Ihsan Academy authorization to request cumulative record file from your child's current school? *YesNoParent/Guardian SignatureThe electronic signature below, and all of its related fields, replaces a handwritten signature on paper and is legally binding. By submitting this application, I accept the admission process. I have read the application process and I affirm that the information provided is true, correct, and complete, to the best of my knowledge and belief. This electronic signature below and its related fields are treated by OIA like a handwritten signature on a paper form. Additionally, by signing below, I give Ohio Ihsan Academy authorization to request the cumulative record file from my child's current school. Electronic Signature *Yes I AgreeName *FirstLastSignature Clear Signature Current Date Date is: Email *Email confirming receipt of this form will be sent to this addressNon-refundable application feeNon-refundable application feeNon-refundable application fee$0.00Square *CardName on CardPlease be informed that upon submission of your application, an email containing in-person interview time options will be promptly sent to you. SubmitSave and Resume Later Your form entry has been saved and a unique link has been created which you can access to resume this form. Enter your email address to receive the link via email. Alternatively, you can copy and save the link below. Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted. Copy Link Email * Send Link
