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APPLICATION FORM FOR ENROLLMENT TO MADRESSAH
Please complete the application form below.
You will be notified in due course when your child is to be offered a place.
Please ensure that you have studied the rules and regulations carefully.
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* Indicates required question
Name of Child
*
Your answer
Gender
*
Male
Female
Child Date of Birth
*
MM
/
DD
/
YYYY
Name of Parent /Guardian
Your answer
Email
*
Your answer
Address:
*
Your answer
Phone number
*
Your answer
Does the child suffer from any ailments or medical / mental conditions? If so please give details (in strict confidence)
*
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
*
Your answer
Accept terms
*
I have understood the Madressah terms and conditions as per
norbury.org/madressah-terms
Required
Name of person filling in applicant
*
Your answer
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