Course Registration Form

Rumi House Logo

email: info@rumihouse.org
contact number: 571 634 2003
address: 4900 Leesburg Pike, Suite 203 Alexandria, VA 22302

Important Notice Before Completing the Form

  • This form must be completed by the father, mother, or a legally authorized family member who is responsible for the information provided.
  • The person completing the form is responsible for the accuracy and validity of all submitted information and documents.
  • Sensitive information, including date of birth, proof of residence, medical records, and vaccination documents, must be correct and valid.
  • After final approval by the school administrator, the information will be entered into the official database, and any changes are only allowed with the administrator’s permission.
Select the course type(Required)

1. Parent/Guardian Information

Full Name of Father/Mother or Legal Guardian(Required)
Legal parent or guardian of the student
For urgent contact
Secondary contact number
Primary email for school communication
Secondary email for school communication
Residential Address(Required)
At least one of the following must be provided:
  • Valid lease or property ownership document
  • Utility bill (electricity, water, or gas) dated within 60 days
  • Bank statement or rental/home insurance statement
  • Other documents approved by the school
Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.

Student Basic Information

Name(Required)
Must match official ID document
MM slash DD slash YYYY
Birth Certificate or Passport. At least one required
Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.
Gender

Academic Records

Include school name and address
For transferred students
Upload file if available
Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.

Health and Vaccination

Parent/guardian responsible for providing accurate information
Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.
Parent/guardian responsible for providing accurate information
Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.

Additional Information

Required for legal registration if available
Final approval by the school

Parent/Guardian Consent and Confirmation

Consent Checkbox(Required)
Option to Edit Before Final Approval Parent/guardian can edit information before administrator approval

Form Completer Information

Father, Mother, or Legal Guardian
Example: Mother, Father, Legal Guardian
Confirms accuracy of information and legal responsibility
Confirms accuracy of information and legal responsibility