Academy · Ages 4–15

Apply for a place.

It takes about five minutes. The office will be in touch once we've received it.

1Your child

Child 1

First nameLast nameDate of birth

Boy or girl

BoyGirl

Year group in schoolHow many surahs memorised?

Qaidah completed

Has been to another madrasah

Medical information and allergiesPlease list any allergies (including nuts) and medication. Leave empty if none.

Applying for brothers or sisters? Add them here, so you only fill in your details once.

2You (parent or guardian)

Your nameRelation to the childFor example: mother, father, guardianEmailPhone numberEmergency contact nameEmergency contact numberAddressPost code

3Brothers and sisters

I have other children already at the Academy

4Fees and agreement

£190 a term (about 12 weeks), paid at the start of each term. A one-off £20 admission fee per child. £15 off each additional child from the same family, every term.

I understand that attendance on both Saturday and Sunday is mandatory.

I have read the nut allergy policy.

I confirm that the information given on this form is true to the best of my knowledge. I will ensure the fees are paid in their due time and agree to abide by the conditions set.

How we use your details: privacy notice.

* must be filled in