APPLICATION FORM FOR ENROLLMENT TO MADRESSAH

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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.

Name of Child *

Gender *

Male

Female

Child Date of Birth *

YYYY

Name of Parent /Guardian

Email *

Address: *

Phone number *

Does the child suffer from any ailments or medical / mental conditions? If so please give details (in strict confidence) *

Emergency Contact Name

Emergency Contact Phone *

Accept terms *

I have understood the Madressah terms and conditions as per norbury.org/madressah-terms

Required

Name of person filling in applicant *

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