Re-enrollment

Re-enrollment Application

This online re-enrollment form is for current Madina Academy families. If you are enrolling children for the first time, please visit the enrollment page and download the necessary documents.

Parent Information

Please fill in both parents' information.

* Indicates required field

Father Name *

Father's E-mail *

Father's Phone Number *

Would you like to receive text messages on this phone number? *

Mother Name *

Mother's E-mail *

Mother's Phone Number *

Would you like to receive text messages on this phone number? *

Home Address/Phone

Home Address *

City *

State *

Zipcode *

Home Phone *

Children Information

Please fill in the following information for each child. If additional field are needed, please add them to the comment section at the end.

1st Child's Name *

Returning Status *

Incoming Grade *

2nd Child's Name *

Returning Status *

Incoming Grade *

3rd Child's Name *

Returning Status *

Incoming Grade *

4th Child's Name *

Returning Status *

Incoming Grade *

Medical Information *

Additional Information/Comments *

**Please note that application submission is NOT COMPLETE until the re-enrollment fee is paid and all required forms are submitted.**

Submit Application

Re-enrollment Application​for Current Parents

Re-enrollment Application

​Parent Information

Home Address/Phone

Children Information

Please note that application submission is NOT COMPLETE until the re-enrollment fee is paid and all required forms are submitted.

Re-enrollment Application
for Current Parents

Parent Information

**Please note that application submission is NOT COMPLETE until the re-enrollment fee is paid and all required forms are submitted.**