Madrassa Enrolment Form

Enrolment Required (Please tick all preferences) *

• HIFZ
• Weekdays
• Weekend

Student Name *

First

Last

Date of Birth *

Gender *

• Male
• Female

Address *

Post Code

Home Telephone No. *

Mothers / Guardians Name *

Address *

Post Code

Mobile Phone Number

Home Phone Number

Email *

Fathers / Guardians Name *

Address *

Post Code

Mobile Phone Number *

Home Phone Number *

Email *

Is your child currently attending or has he/she attended a Madrassa *

• Yes
• No

If YES please answer the questions below and provide as much detail as possible. Name of Madrassa

Address of Previous Madrassa

Contact Name at previous Madrassa

Contact Number at previous Madrassa

Period of Attendance (Years/Months)

What is the child’s current stage of Qur’aan learning i.e. Qaidah or Juz / Para’s completed or memorised

Qur’an Hifz Completed

• Full
• Partial
• With Tajweed

Number of Para’s Completed

Selected Value: 0

Qur’an Nazira

• Full
• Partial
• With Tajweed

Para Number

Selected Value: 0

Qaid’ah

• Qaid’ah

Name of Doctor *

Medical Consent

Surgery Name *

Address *

Post Code

Telephone

Applicants Medical Number

Does the applicant suffer from any serious long term illnesses? (e.g. Epilepsy, Asthma - if yes please give details) *

• Yes
• No

Details

Does the applicant suffer from and allergies? (eg: Nut allergy etc, - if yes please give details)

• Yes
• No

Details

Does the applicant require and special (educational and other) needs? (if so please give details) *

• Yes
• No

Details

GDPR – Consent for Personal Information Usage by GBMF *

• I grant my consent to GBMF to store personal details of my children attending M storing his personal details for the purpose of his Islamic education and all administrati Madrassa provision by GBMF. I do not authorise it to be used for any other purpose.

I grant my consent to GBMF to store my personal details for sending me emails, Whatsapp/SMS text messages. I have provided my personal data for the purpose of receiving such communications from GBMF. I do not authorise it to be used for any other purpose. *

• Agree

Declaration I hereby declare that I have read the admissions rules and I agree to abide by them and all Madrassa rules and regulations thereafter. I further declare that the information given on this application form is accurate and to the best of my knowledge. *

• Agree

I agree to GBMF having CCTV in children’s classrooms, for security and safety purposes. *

• Agree

Signature of Parent/Guardian (Please Type in full name) *

Submit