New Muslims Application Form

Please contact Mosque office if you would like to complete an online form.

Student ID
Islamic Centre EdgwareMadrasahApplication Form
PLEASE COMPLETE IN CAPITAL LETTERS AND RETURN ALONG WITH:
Recent Passport-sized Photograph / Completed Standing Order Form / Proof of Address (utility bill, bank statement, council tax notice) not more than three months old
Childs Certificate of Birth / Recent School Report
Class applied for: / Monday – Thursday, 5:00pm – 7:00pm / Saturday – Sunday, 11:00am – 1:00pm
Section 1 Child’sDetails
First Names: / Last Name:
Address:
Postcode:
Gender: / Male / Female / Date of Birth: / Age
Country of Origin / Languages Spoken
Preferred School of Thought / Don’t know Hanafi Shāfi’ie Māliki Hanbali None
Does the child have a learning difficulty? / Yes No / Does the child have a behaviour issue? / Yes No
Please give details of any allergies, special needs, medical conditions or medication being administered:
Section 2 Previous Education
Level of Qur’ān reading attained: / Total Beginner / Completed Qaida / Able to recite Qur’ān
Level of tajweed / Good Average Poor / How many juz memorised
Able to perform wudū’ / Yes No / Able to perform salāh / Yes No
Please give details of any other Islamic studies undertaken:
Name of previous madrasah attended:
Address: (or website if online)
Postcode:
Date of starting: / Date of leaving:
Reason for leaving:
Section 3 Parent or GuardianDetails
Father / Mother
First Names: / First Names:
Surname: / Surname:
Address and postcode:
(if different) / Address and postcode:
(if different)
LandlineTel: / LandlineTel:
Mobile Number: / Mobile Number:
E-mail address: / E-mail address:
Section 4 Next of KinDetails
Please give details of two additional people who can be contacted in an emergency during madrasah time
Name: / Name:
Relationship: / Relationship:
LandlineTel: / LandlineTel:
Mobile Number: / Mobile Number:
E-mail address: / E-mail address:
Section 5 Declaration
I hereby apply for admission for my child to Islamic Centre Edgware madrasah. I understand that any inaccurate information may result in my application being disqualified.
I have read and agree to abide by the Policies, Rules and Regulations of Islamic Centre Edgware.
Signed: / Date:
Completed forms should be returned to:
Islamic Centre Edgware, 9d, Deansbrook Road, Edgware, HA8 9BE
020 8728 3798 | |
Office Use Only
Date Application Received: / Application Received by:
Proofs Checked: / Standing Order Completed:
Islamic Studies Assessment: / Tajweed Level Assessment:
Date Admitted: / Admitted By:
Additional Comments: