Form

Parent/Guardian #1 Details:

Parent First Name*

Parent Last Name*

Email Address *

Phone Number *

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Relationship to Child*

Parent/Guardian #2 Details:

Parent #2 First & Last Name*

Please put "n/a" if you are a single parent

Parent #2 Email

Parent #2 Phone

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Parent #2 Relationship

Zaytech Academy needs the contact information you provide to us to contact you about our products and services. You may unsubscribe from these communications at any time. For information on how to unsubscribe, as well as our privacy practices and commitment to protecting your privacy, please review our Privacy Policy.

Basic Details

What school year are you interested in applying for?*

Have you taken a tour of our campus?*

Yes

What is your current Home Address?

Street Address, City, State, Zip Code*

For example: 1234 Olive Court, Tracy, CA 95376

Will you be relocating to attend Zaytech Academy?*

Yes

Unsure

Financial Information

Household Size*

Total # of people in your household

Household Income*

Gross Estimated Amount (Before Taxes)

Student #4 Details

Please only enter data for one child at a time!

First, Middle, & Last Name*

Gender*

Female

Male

Date of Birth*

Grade Level*

School Track*

School Track Definitions:

Regular Academics = Islamic & Quranic Studies, Language Arts, Math, Science, & History
Hifdh & Academics = Quran Memorization, Language Arts, Math, Science, & History
Only Hifdh = Quran Memorization at Zaytech Academy, academics completed elsewhere

*Hifdh Requirements: 5th Grade and above, must pass memorization readiness evaluation by Zaytech Academy Hifdh teachers

What school does your child currently attend?*

You're Almost Done!

Please carefully read everything on this page before submitting.

Parent Confirmation

By checking this box, I (the parent submitting this form), hereby declare that the information provided in this application by me is true and accurate. I also understand that any willful dishonesty or hiding of any information may render for denial of my child(ren)'s enrollment at Zaytech Academy indefinitely. *

Application Fee

Please use this link to submit the application fee ($150/child) before proceeding: LINK TO PAY

By checking this box, I (the parent submitting this form), hereby declare that I have paid the application fee per child using the link provided above. Failure to submit this form without paying the application fee will result in the denial of your application.*

Next Step

Once you click the "Submit" button below, you will be redirected to complete the second part of Zaytech Academy's application packet, the Enrollment Application Questionnaire. Both forms (this one and the Questionnaire) are required to be completed, otherwise your application cannot be accepted.