baitulmukarram-nz@outlook.com 02102624169

Student Enrollment Form

Madrasah tul Mukarram

Learn the Deen of Allah Ta'ala

Enroll your child now for year 2024

Please read the Madrasah Infomaition booklet.

Student's Information (Child 1)

Student 1 Full Name

Date of Birth

Age

Main language spoken by your child

Medical Health/ Allergies

My Child Will do

Tasheel Grade

Student's Information (Child 2)

Student 2 Full Name

Date of Birth

Age

Main language spoken by your child

Medical Health/ Allergies

My Child Will do

Tasheel Grade

Student's Information (Child 3)

Student 3 Full Name

Date of Birth

Age

Main language spoken by your child

Medical Health/ Allergies

My Child Will do

Tasheel Grade

Parent Information

Father's Name

Father's Occupation

Father's Contact number

Mother's Contact number

Home Address

Email-id

Whatsapp Number: The Madarsah uses Whatsapp to send messages to parents, please provide Whatsapp numbers:

Father's Whatsapp number

Mother's Whatsapp number

In case of EMERGENCY the Madarsah should contact

Guardian's Name

Relation with the student

Guardian's Number

Declaration

We have read the Madarsah Information booklet. We agree with all its content. And we will do the best of our ability to abide to the rules and regulations of the Madarsah.

I agree