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ICN Alimiyyah Programme Registration Form
Please fill in the following registration form to register for the Alimiyyah programme.
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Email *
Surname *
Forename *
Home Address *
Postcode *
Tel: Home *
Tel: Mobile *
E-mail *
Gender *
Age *
D.O.B *
Parent / next of kin details: Surname *
Parent / next of kin details: Forename *
Parent / next of kin details: Home Address *
Parent / next of kin details: Postcode *
Parent / next of kin details: Tel: Home *
Parent / next of kin details: Tel: Mobile *
In 500 words or less, please describe any details about your personal background, especially with regards to your experience in Islam, that you believe would support your application. *
To facilitate your learning we would like to know about your secular educational background in order to best cater for your academic needs. Please tell us about any academic qualifications you have obtained. *
Your expectations and objectives: Please tell us about (1) your expectations of the course and (2) your objectives for attending. Please make sure to attempt both parts of this question. *
Please tell us about your Islamic education, teachers, and your interests. i.e. have you attended any institutions or which classical books have you been through if any? *
Which method of study do you prefer? *
Would you require accommodation? *
Do you have any medical conditions or requirements i.e. asthma / any allergies? *
If you answered yes to the previous question, please provide further details regarding your medical conditions or requirements. If no, please write N/A. *
Declaration: I declare the information I have provided to be true to the best of my knowledge and I agree to abide by the rules and regulations of the institute. Please write your full name in upper case and then the date. *
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