Step 1 of 3 33% Parent's / Guardian Contact Information Parent or Guardian Name* First Middle Last Title*Occupation*Parent's Email* Enter Email Confirm Email Phone Number*How did you hear about the Bayaan Academy? (If referred, please mention name of the person referring)*Please explain why you feel that online learning would be a good fit for your child.*With limited seats for enrollment for each grade, we want make sure that Bayaan Academy is a good fit for you and your family. Student Contact Information Student's Name* First Middle Last Student Email Address ( If any ) Phone*Date Of Birth* Date Format: DD dash MM dash YYYY Current Grade Level*Does the student have any special needs or learning disabilities?*Describe any areas in which your student may need additional support.*Please respond accurately so teachers and administration can provide additional supports as needed.Permanent Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Former School Information Current or Former School Name*School Phone Number*Years Attended* Admission & Payment Details Please Select Grade for Admission*Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Select Program*--------Full Live Academy, $3250/yearPartial Live Academy, $2750/yearCurriculum Support, $950/yearLive Islamic Studies Only, $1250/yearFull Homeschool Package, $1550/yearSelect Time* 9am-1pm EST (4pm-7pm Makkah) 12pm-5pm EST Do you want to sign up for electives?*YesNoPlease Select Elective Subjects 3D Animation App Design Server Design 3D Game Development Elective courses are extra and paid for the complete course at a time. Elective Subject Fee Price: $149.00 Elective Subject Fee Price: $149.00 Elective Subject Fee Price: $149.00 Elective Subject Fee Price: $149.00 Initial tuition deposit* Price: $300.00 There is no admission fee. We only require an initial payment of $300. Your monthly payment will reflect this payment.Total $0.00 Agreement: By clicking submit, you agree to the annual tuition fee which are payable on a monthly basis. You will be sent monthly invoices. Credit Card* American ExpressDiscoverMasterCardVisaJCB Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name