Cognia Accredited K12 Islamic School

We Are Accepting New Students

Enroll Now For The 2022-2023 School Year

Charlotte Islamic Academy, the only Accredited K12 Islamic School in Charlotte, NC is now enrolling Preschool to 12th-grade students for an exciting school year ahead! Since 1998, our close-knit educational community has been promoting academic excellence and the social development of all students in a pure Islamic environment. We look forward to welcoming you to our school!

Complete Registration In 2 Steps!

Step 1: Registration Fees (NON-REFUNDABLE)

Parent/Legal Guardian Information

Who is completing this form? *---Choose---Parent(s)Legal Guardian, Other Than Parents

Name of legal guardian who is completing this form *

First

Last

Legal Guardian's Email Address *

Legal Guardian's Cell Phone *

Legal Guardian's Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Legal Guardian's Employer *

Legal Guardian's Business Phone *

Preferred contact method *---Choose---PhoneEmailText MessageNo Preference

Father Name : *

First

Last

Father's Email *

Father's Cell Phone *

Father's Employer *

Father's Business Phone *

Father - Preferred contact method *---Choose---PhoneEmailText MessageNo Preference

Mother Name : *

First

Last

Mother's Email *

Mother's Cell Phone *

Mother's Employer *

Mother's Business Phone *

Mother - Preferred contact method *---Choose---PhoneEmailText MessageNo Preference

Who is the preferred contact person? *---Choose---MotherFatherOther, specify

Who is the preferred contact person? *---Choose---Legal GuardianOther, specify

Other Contact's Name & Phone Number *

Student(s) primarily lives with? (Needed for Jupiter grades) *---Choose---Both Parents, Address Same As Student'sFatherMotherLegal Guardian

Relationship to the child(ren) *

Registration Fees Due

Total number of children to enroll. *---Choose--1 Child 2 Children 3 or more Children

PLEASE NOTE: All registration fees are to be paid before completing this application. Registration fees are as follows:

• 1 student = $100
• 2 students =$175
• 3+ students = $250

If you are enrolling 3 or more children the rate remains the same $250 for all children unlimited.

Student Information

Primary Residence Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Student's Name *

First

Last

Student's Date of Birth *

Student's Gender *---Choose---MaleFemale

Student's Place Of Birth (City, State, Country) *

Student's US Citizenship? *

• Yes
• No
• Other

Student's Other Citizenship? *

I am enrolling my child for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Student 1 Information

First Student's Name 1 of 2 *

First

Last

First Student's Date of Birth *

First Student's Gender *---Choose------Choose---MaleFemale

First Student's Place Of Birth (City, State, Country) *

First Student's US Citizenship? *

• Yes
• No
• Other

First Student's Other Citizenship? *

I am enrolling child 1 for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Student 2 Information

Second Student's Name 2 of 2 *

First

Last

Second Student's Grade: *

Second Student's Date of Birth *

Second Student's Gender *---Choose------Choose---MaleFemale

Second Student's Place Of Birth (City, State, Country) *

Second Student's US Citizenship? *

• Yes
• No
• Other

Second Student's Other Citizenship? *

I am enrolling child 2 for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Student 1 Information

First Student's Name 1 of 3 *

First

Last

First Student's Grade: *

First Student's Date of Birth *

First Student's Gender *---Choose------Choose---MaleFemale

First Student's Place Of Birth (City, State, Country) *

First Student's US Citizenship? *

• Yes
• No
• Other

First Student's Other Citizenship? *

I am enrolling child 1 for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Student 2 Information

Second Student's Name 2 of 3 *

First

Last

Second Student's Grade: *

Second Student's Date of Birth *

Second Student's Gender *---Choose------Choose---MaleFemale

Second Student's Place Of Birth (City, State, Country) *

Second Student's US Citizenship? *

• Yes
• No
• Other

Second Student's Other Citizenship? *

I am enrolling child 2 for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Student 3 Information

Third Student's Name 3 of 3 *

First

Last

Third Student's Grade: *

Third Student's Date of Birth *

Third Student's Gender *---Choose------Choose---MaleFemale

Third Student's Place Of Birth (City, State, Country) *

Third Student's US Citizenship? *

• Yes
• No
• Other

Third Student's Other Citizenship? *

I am enrolling child 3 for grade.... *---Choose---PreK1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10the Grade11th Grade12th Grade

Print name *

First

Last

Signature Required *

Clear Signature

Select Today's Date *

Website

Register

Step 2: Download & Complete The Registration Form

New Students – Preschool Only

1. PRE K Application 2022-2023
2. Financial Agreement – Automatic Withdrawal Form 2022-2023

New Students K-12th Grade

1. New Student Application 2022-2023
2. New Students Registration form 2022-2023
3. For Transferring Students – Student Record Request 2022-2023
4. Financial Agreement – automatic Withdrawal Form 2022-2023

Existing Students/ReEnrollment

1. Re-Enrollment Application 2022-2023
2. Financial Agreement – automatic Withdrawal Form 2022-2023

Resources For All Parents – Please Review

• UNIFORM POLICY FOR GIRLS 2022-2023
• UNIFORM POLICY FOR BOYS 2022-2023
• BASIC RULES FOR PARENTS 2022-2023 
• Free Book List 2022-2023

Registration paperwork can be submitted at the school or can be mailed to the school. Please submit all of the required documents and fees. These are mandatory for registration completion.

Please Note The Following

Charlotte Islamic Academy has a non-discriminatory policy that it follows and which provides students an opportunity to receive a comprehensive education without any regard to race, color, nationality, or ancestry.

Before any student is allowed to attend school at Charlotte Islamic Academy parents/guardians must:

• Provide a copy of the following

  • Birth certificate
  • Immunization records
  • Previous School Records

• Non-refundable registration fees

  • $100.00 per child, 2 students $175.00, 3 or more children $250.00 per family.
  • Uniform fee for boys, minimum of $40.00 (based on your choice of uniforms)
  • Monthly Payment plan fee of $50.00 Yearly or Bi-Yearly plan fee of $10.00
• Because of limited space, Charlotte Islamic Academy reserves the right to select students who have exam scores of 80% and above.

• Admissions will be based on a first come first serve system once all prerequisites have been met.  You will be notified by Charlotte Islamic Academy when the admission process is complete and acceptance has been granted.
•  If you have any questions, please contact Sister Muna Nasralla at 704-900-0255 or email officemanager@ciacademy.us

If you would like, you can mail your complete registration applications with fees to the following address:

Registration Dept

Charlotte Islamic Academy

8310 Harrisburg Rd

Charlotte, NC 28215

officemanager@ciacademy.us