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Muhammadi Madrasah January 2019 Enrolment Form
This form is to be used to enrol a child to join Muhammadi Madrasah (Sunday) for the academic year commencing January 2019. Please note that a child can only join Madrasah if they are 4 years old as at 31/08/2018 (i.e. eligible to start school reception year in September 2018. Applications received for children who are under the age of 4 years on 31/08/2018 will not be considered.

The maximum number of entries into P1 is 22. Other criteria to be met as well as per admissions policy

Applications for other years will be subject to places available as well as meeting all criteria as per the Admissions Policy.

Members of the KSIMC of Birmingham will be given priority over other applicants

Special Needs Information
Muhammadi Madrasah offers equal opportunities to students of all abilities. We have a dedicated Guided Learning Class where students are given tailored support to maximise their Islamic learning. In the case that a child without a disclosed SEN or IEP is identified as requiring additional support, you will be contacted by the Madrasah to discuss it further.

The application window will be open from 9:00pm on Monday 10th September 2018 to 11.59pm on Monday 08th October 2018

To start the application, please enter your e-mail address (the person filling in this form).

On submitting an application, you will receive an e-mail (from google forms) confirming the submission of the form. If this e-mail is not received, the application will NOT have been received by us.

Email address *
Child's First Name *
Your answer
Child's Surname *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Religious Denomination *
Correspondence Address *
Your answer
Father's Name *
Your answer
Mother's Name *
Your answer
Who has parental responsibility of the child? *
If your response for the previous question is 'other', please provide name and your relationship to the child
Your answer
Who does the child live with? *
If your response for the previous question is 'other', please provide name and your relationship to the child
Your answer
Primary Telephone Number [Landline] (please write not applicable if none) *
Your answer
Primary Telephone Number [Mobile] *
Your answer
Secondary Telephone number [Landline]
Your answer
Secondary Telephone number (Mobile)
Your answer
Secondary E-mail address
Your answer
Does the child have any allergies? *
Does the child have any medical conditions? *
Family Doctor's name and contact details *
Your answer
Does the child have any Individual Education Plan [IEP]/Special Education Needs [SEN] at school? *
May we use your child's photograph in printed promotional publications and/or on our website and/or display boards both in and out of the Madrasah? *
May we use your child's image on video or involve them to feature on video? *
Has your child previously attended any other Madrasah in the past *
If you answered yes to the previous question, please provide the name of the Madrasah the child attended
Your answer
Is your child currently home-schooled? *
Does the child have any other siblings who attend Muhammadi Madrasah *
Are you a member of KSIMC of Birmingham Jamaat *
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Required
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Required
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Required
Name of person completing the form *
Your answer
A copy of your responses will be emailed to the address you provided.
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