Madrassah Application Form
Maktab and Hifdh Class
Sign in to Google to save your progress. Learn more
Are you applying for *
Child's First Name *
Child's Surname *
Gender *
Date of birth *
Enter child date of birth (Separate by / )
MM
/
DD
/
YYYY
First Line of Your Address *
Please enter your door and Road name
Second Line of your Address
Optional
Post Town *
Pick your Post Town
City *
Enter City
Post Code *
Enter Post Code
Landline (put mobile if you do not have landline) *
Enter Landline Number [NO SPACING BETWEEN NUMBER]
Mother’s Full Name *
Mother’s Mobile Number *
Enter your Mobile Number  [NO SPACING BETWEEN NUMBER]
Mother’s Email Address *
Father’s full Name *
Father’s Mobile Number *
Enter your Mobile Number  [NO SPACING BETWEEN NUMBER]
Father’s Email *
Parental responsibility *
Medical or Learning Difficulty Details *
If your child suffers from any medical conditions, behaviour issues, or learning difficulties,
If Yes *
Please give details:
Session *
Session one 4:30 - 5:30 | Session two 5:30 - 6:30. | Hifz   4:30PM - 6:30PM
Do you have other children currently enrolled in Madrasah? *
Please tell us any children of your already in Maktab
If Yes
Please enter all children name below
Who will Drop and Pick up your Child *
Please select who your child will travel with, to and from Madrasah
If other than parents who will pick up and drop
Please specify below:
Parent or Guardian: *
Enter  name parent or guardian:
Relationship to child *
Enter  parent or guardian relations
Has your child completed Nazirah (recital) of the Qur’an?
Clear selection
Has your child memorised any surahs/juz of the Qur’an?
Clear selection
If Yes, which surahs/juz
Has your child taken any lessons in Tajweed?
Clear selection
Consent *
Required
Declaration
I here by agree to abide by the rules and regulations of the Madrasah  and I undertake the responsibility to pay the fee of  £28 per month per child for Maktab and £56 per month for hifz.

• Fees must be paid during absence, as the child’s place will be kept reserved.
• Fees must be paid one month in advance.
Declaration *
Please select option YES  if you are agree No if disagree
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy