Admission Form for Elementry and Middle School

• Included in The Packet:
  • Elementary & Middle School Admission Registration Form
  • Physical Activity Statement
  • Media Release
  • Hifz Program Registration - Optional
  • Child Care Sick Policy
  • Authorization for Emergency Treatment Form
  • Parent Responsibility Form
  • Student Records Release Form
• NOT Included in Packet - Required from Parents:
  • Student Birth Certificate
  • Florida Certification of Immunization: Form DH-680
  • OR Religious Exemption Statement Form DH-681 signed by the Florida Department of Education
  • School Health Entry Form: DH-3040
  • Registration Fee
  • Scholarship Award Letter - If Applicable

If the child is not living with both parents, the legal guardian must provide a proof of guardianship and fill out the
section below:

I/We [Field 1] am/are the legal custodian(s) of [Field 2], and has/have legal authority and the corresponding duty in regard to his/her education.

I certify that the information given in this application is complete and accurate and understand to make false
statements within this application may result in the withdrawal and/or termination of admission. I agree to
support and abide by the Salah Tawfik Elementary & Middle School regulations, policies, and guidelines for
admissions and attendance.

If prescribed medication is necessary to be administered during school hour, please request a separate Authorization form complete and return the form to the office.

Please list at least two emergency contacts below in the event that the Parents and/or Guardians can’t be reached. These individuals will also have authorization to remove the student from the school and pick up the child during dismissal.

• For all children's safety, it is critical for you or your authorized pick-up individuals to use your
  dismissal card to pick up your child. To ensure the safety of our school's staff and children, please keep your card in a secure location.
• Please notify your authorized pick up individuals that they must bring government-issued identification when they pick up your child.
• If your child(ren) is/are picked up after dismissal has ended, a late pick up fee of $10.00 for every 15 minutes will be added to your monthly invoice.
• Salah Tawfik Elementary and Middle School reserves the right to contact and request the
  individuals above to pick up your child if he/she is not picked up by 3:40pm. In such cases,
  local authorities may be contacted.

Anyone not on this list MAY NOT pick up your child(ren) without prior approval from the parents or legal
guardian. NO EXCEPTIONS. This is for the safety of all our students.

Dear Parent or Legal Guardian:
Children will be participating in structured physical education activities of at least a moderate intensity level and for a duration sufficient to provide significant health benefits, subject to the differing capabilities of students.

During the school year, photographs, audio and/or video recordings of our school, students and teachers may be taken for the purpose of promoting the school. These photographs and/or recordings may be used in the various mediums of advertising such as brochures, social media, websites and other publications.

• I affirm that, to the best of my knowledge, all statements made herein are true and complete. I understand that any admissions into Salah Tawfik Elementary & Middle School is contingent upon accurately completing this application and submitting the required supporting documents, records and transcripts. Furthermore, a placement test may be required for all new and returning students.
• I understand that a non-refundable registration fee must accompany this application and admission is not guaranteed. Salah Tawfik Elementary & Middle School does not discriminate on the basis of color or race, color, religion, national or ethnic origin, or sectarian affiliation in the administration of its educational policies, admissions policies or decisions, scholarship programs and other administered programs.
• I undersigned, parent or Guardian, release Salah Tawfik Elementary & Middle School, their respective agents, officers, employees and volunteers from any liability, including injuries or illness, which may result from my child's enrollment in the school and waive any claim related thereto.
• I understand that this application for admission to Salah Tawfik Elementary and Middle School does not admit my child unconditionally, but the school reserves the right to accept or reject a student on the basis of previous school records, testing, and personal interview.

This program is optional for parents who are interested. If not, please ignore this page.

Hafiz Program

Salah Tawfik Elementary and Middle school offers a full-time Hifz Program The curriculum integrates intensive Hifz instruction with core curriculum academics.

Prerequisites for the Hifz Program are as follows:

• We accept both boys and girls from Grades 6-8
• Students must have A’s or A & B letter grades in all subjects.
• The student must be well versed in reciting the Quran and should have the ability to retain memorized sections.
• Students should have the capacity to memorize at least one page a day.
• Admission is based on the teacher’s assessment of the student. The probationary period is 90 days.
• Hifz students will be evaluated annually for their performance of Hifz and academics.

Becoming a Hafiz takes a lot of hard work and dedication from the student as well as the parents. We cannot place an exact time frame on how long it will take to become a Hafiz. Some students take less than one year to memorize the Quran, while some students take up to three years or more. Our goal is to offer the student a supportive environment that is conducive to memorizing the Quran so that they may never forget it.

Children in child care environments are exposed to germs carrying disease and illness. The spread of disease cannot be completely prevented but this Child Care Sick Policy will help us to reduce the spread of illness whenever possible for all the children in our care.

• Teachers cannot provide care for a sick child when this places the health of other children at risk. Please keep your child at home if s(he) is sick. A child that is sick cannot participate in daily activities and routines and cannot be successful in group care.
• Each morning, and periodically throughout the day, our teachers perform quick health assessments on all children. If your child is found to be ill upon arrival, you will be asked to take your child home. If a child becomes ill while in our care, we will notify you so that you can make arrangements to pick up your child as soon as possible.
• If you are not reachable, we will contact one of your emergency contact persons to pick up your child. You must provide local emergency contacts with appropriate phone numbers (for example cell phones, not just the home or work phones). If you are asked to take your child home due to sickness and you are not able to keep them at home to care for them, you must have a plan for backup care.

You will be asked to pick up a child who has:

• Fever with signs or symptoms of illness: an oral temperature of or over 100.4˚ F or under the armpit (axillary) temperature of or over 99.4˚ F.
• Diarrhea.
• Vomiting.
• Note: In case of fever, diarrhea and/or vomiting, the child should not return to school until 24 hours have passed since the last sign of the symptom.
• Sore throat or difficulty swallowing.
• Headache or stiff neck.
• Severe itching or rashes.
• Mouth sores.
• Significant tiredness, irritability, crying.
• Difficulty breathing, chronic coughing or wheezing.
• Unusual nasal discharge.
• Constant pain in the stomach.
• Behavior that seems slow, confused or disoriented.
• Any contagious condition including ringworm, bedbugs, head lice, pink eye.

These symptoms listed above may or may not be associated with a communicable illness, but without the consultation from a healthcare professional it is impossible to determine the nature of the illness. Therefore, you will be required to pick up your child and you will be responsible for arranging any further evaluation or assessment of their healthcare needs.

Communicable Diseases

• You are required to notify the teacher immediately of any life-threatening diseases your child may have been exposed to.
• You are required to notify the teacher within 24 hours if your child or a member of your immediate household is diagnosed with a common, non-life-threatening communicable disease (such as flu or pink eye).
• The teacher will notify all parents within 24 hours if a communicable disease has been reported in your child's class.
• You will be asked to bring a note from a doctor or health care professional stating that the child may return to health care and is no longer contagious.

I have read, understood and agree to the Sick Child Care Policy of Salah Tawfik and my signature below is
confirmation of this fact.

Required by the Broward County of the State of Florida

In order to comply with the Broward County Child Care Code, please provide us with the following information: The Child Care Provider shall have written instructions from the parent for the school to follow arranging for immediate treatment for your child in an emergency situation.

1. By providing my signature below, I give the Islamic Foundation of South Florida and Salah Tawfik Elementary and Middle Schools authorization to seek medical treatment for my child if I or any other persons whom I have listed to be notified in case of an emergency cannot be reached.
2. By providing my signature below, I give any health facility or physician permission to provide medical treatment for my child as deemed necessary in any situation which may arise at the school.
3. By providing my signature below, I will take full responsibility for payment of all medical services which might be rendered due to any emergency situation that may arise at the school.

I hereby give my consent to [Field 1] to administer necessary treatment to my child [Field 2] in the event of an emergency at which time I cannot be reached. I also give consent to transport by ambulance if the situation warrants it.

I, the undersigned parent/guardian, agree to comply with the financial and enrollment policies stated in the Salah Tawfik Elementary and Middle School Handbook. I understand and agree to pay for all tuition fees and services. Additionally, I understand that the registration fees are NON- Refundable.

Billing

We use FACTS Tuition Managements for our billing. All Families must set up an account at registration and establish their FACTS monthly payment plan. Accounts must be setup and a payment method must be set up before the first day of school. Otherwise we accept check, cash, or debit/credit card payments at the schools location.

Please sign your initials on the following policies regarding billing:

I understand that tuition that is returned due to bounced checks will be charged a fee of $30 plus any bank fees incurred by STEMS. Tuition that is not kept current, within the month it is due, may lead to the dismissal of your child until payments have been made.

I understand that School Year Enrollment is made for the entire school year. STEMS are not a drop-in program. Tuition is due regardless of attendance.

I understand that tuition is billed monthly for ten equal monthly payments – the last payment of the school year is due the last day of May, unless an exception is made otherwise.

I understand that If my student is enrolled in our Hifz Program, I must take full responsibility for paying monthly Hifz Fees. Hifz fee is due at the same time with tuition fees.

Enrollment of a student for one year therefore does not guarantee enrollment for the subsequent school year.

No tuition refunds or credits will be given for days your child is absent. National holidays or Hurricane Days. If your child is sick: you are still responsible for the tuition.

I understand that the tuition amount remains the same and is billed on a calendar month regardless of whether there are more or fewer days or weeks in the month.

I understand that if STEMS takes legal action against me for the collection of payment due to STEMS and I agree that I must reimburse STEMS for any and all attorney’s fees and costs it incurs in attempting to do so.

Attendance and Pickup

Attendance is mandatory at STEMS. If your child is absent for more than 5 days the office needs a written explanation for the reason of absence. Payment is due even if out sick. If your child is a holder of an SUFS, Mckay, Gardiner or FES Scholarship, 5 consecutive days or 18 total days (yearly) of absence could result in the loss of mentioned scholarship.

• Late Pick-up Fees: Dismissal time at Salah Tawfik is at 3:15 PM and on Friday at 2:15 PM. A late pick-up fee will be charged for picking up your child later than 3:40 PM. A fee of $5 will be charged for every 15 minutes past closing.
  (Please be advised that Salah Tawfik Elementary and Middle School is required to report to the Department of Children & Families repeated tardy pick-ups.)
• Students who participate in any afterschool program must also be picked up on time at the completion of their program. Students who are not participating in any after school program, i.e. siblings, and are under school supervision, will also incur a charge at the same rate.

Parents who are late must park their vehicles and sign their children out in order for them to be released. Fees will be assessed on a monthly basis and charged to your FACT Tuition Management account or can be paid by cash.

If you are going to be late picking up your child/ children in case of an emergency, please call the STEMS office at: 954-741-8130. The late fees will still apply; however, we will be able to assure your child that you are on the way.

Withdrawal Procedures

A parent wishing to withdraw a student must complete a Withdrawal Form which is available at the School Office. Withdrawal is required one week in advance. All student accounts must be paid in full, before withdrawal.
Prepaid tuition beyond the withdrawal date will be refunded. All other fees are non-refundable.

Salah Tawfik Elementary and Middle School reserves the right to expel any student for any reason whatever, including but not limited to infractions of school rules, failure to pay past due accounts, inappropriate parent behavior, and failure to maintain academic standards. STEMS reserves the right not to accept, for any reason, any student for enrollment into the following school year’s student body.

Student records will not be released until all payments are made.

As the parent or guardian of the above named child, I hereby authorize and give consent to service providers and the staff of Salah Tawfik/IFSF as follows:

I hereby consent and authorize the staff of Salah Tawfik/IFSF to take/use still photographs, digital photographs, motion pictures, television transmission, and/or videotaped recordings (hereinafter “Recordings”) of me, my children, or my wards for educational, research, documentary and public relations purposes. Any such ‘Recordings’ may reveal my identity through the image itself without any compensation to me, my children or my wards. Any and all Recordings taken of me shall be the sole property of Salah Tawfik/IFSF. With regard to the use of any Recordings taken of me, my children or my wards, I hereby waive any and all present and future claims I may have against Salah Tawfik/IFSF, their staff, service providers, employees, agents, affiliates and Board members.

I, (Print Parent Name) [Field 1] have received the STEMS Parent handbook link. I have read and understand the Policies and Agreements on this page.

Please be advised that the policies in this handbook are subject to change without prior notice, in the interest of ensuring that the service STEMS provides meets the ever-changing needs of our students.

We acknowledge receipt of the STEMS Parent/Student Handbook for the current school year and agree to abide by the policies/guidelines outlined in the Parent Handbook.

The above mentioned student has enrolled, or is looking to enroll, in Salah Tawfik Elementary & Middle School. Please send their cumulative academic transcripts, standardized test scores, pyschological evaluations, health records, and behavior records as soon as possible.
Thank you.