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Students Details

Parents / Guardian Details

(Landline - Not Mobile)
(This number will be used as primary contact number)

When you are asked to sign the DD mandate for monthly fee, remember to use the same email that you enter here

Emergency Contact Details

(Please provide an emergency phone number to contact in case of the above phone number's are not reachable)

Present Address

Permanent Address

Medical

Does the student suffer from any serious or long-term illness, e.g. Epilepsy, Bronchitis etc?

Does the Student require any special (educational or other) needs?

Does the Student suffer from any allergies?

Consent

If required the following can be administered to the student

Please consent following

Mode of transport that will be used by pupil to and from Madrasah

Do you permit your child to go home alone
(11 and over will be permitted to go on own)

Islamic Education History

Please describe your child´s Quran learning journey and list former teachers and Madrasahs (as detailed as possible)
Please answer the following questions about your child´s Quran level as accurately as possible in order to optimise his/her learning progress.

Submission

How did you hear about our Madrasah?

Submit