Madrassah Admission

Please complete the form below to apply for admission to the Madrassah. You can add more than one student below; the Parent/Guardian, Emergency Contact and Declaration details apply to all students listed.

Child Details

Student

Full Name

Date of Birth (Day/Month/Year)

Gender

Please specify your child's current school

Please list below any medical conditions we need to be aware of, e.g. Allergies, Asthma, Diabetes etc

Do you have any child/ren already attending the Madrassah?

Does your child have any Special Educational Needs?

Parent's/Guardian's Details

Full Name

Relationship to child

Address

Postcode

Home Telephone

Mobile Phone

Email Address

Emergency Contact Details

Same as Parent's/Guardian's Details

Full Name

Relationship to child

Address

Postcode

Home Telephone

Mobile Phone

Declaration

Full Name

Signature

Date

Information

Contact Info

Addmission

Madrassah Admission

Child Details

Student

Parent's/Guardian's Details

Emergency Contact Details

Declaration

Student

Information

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