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(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

Siblings

# Reg No Name Gender Class

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?

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
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.
Is your child able to read the Arabic letters?
How would you describe your child´s reading level?
Has your child studied the rules of Tajweed?
Has your child memorised any portion of the Quran?

How did you hear about our Madrasah?

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