Madrasah Admission Form

First Name

Last Name

Preferred Name

Middle Name

Date of Birth *

Nationality *

Gender

Proposed Date of Entry *

Registration Year Group *
Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Has this student previously studied at Al-Rushd? *

Previous School Name

Does the student have a sibling at Al-Rushd? *

Any additional learning needs required for this student? *

First Name

Last Name

Preferred Name

Middle Name

Date of Birth *

Nationality *

Gender

Proposed Date of Entry *

Registration Year Group *
Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Has this student previously studied at Al-Rushd? *

Previous School Name

Does the student have a sibling at Al-Rushd? *

Any additional learning needs required for this student? *

First Name

Last Name

Preferred Name

Middle Name

Date of Birth *

Nationality *

Gender

Proposed Date of Entry *

Registration Year Group *
Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Has this student previously studied at Al-Rushd? *

Previous School Name

Does the student have a sibling at Al-Rushd? *

Any additional learning needs required for this student? *

First Name

Last Name

Preferred Name

Middle Name

Date of Birth *

Nationality *

Gender

Proposed Date of Entry *

Registration Year Group *
Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Has this student previously studied at Al-Rushd? *

Previous School Name

Does the student have a sibling at Al-Rushd? *

Any additional learning needs required for this student? *

First Name

Last Name

Preferred Name

Middle Name

Date of Birth *

Nationality *

Gender

Proposed Date of Entry *

Registration Year Group *
Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Has this student previously studied at Al-Rushd? *

Previous School Name

Does the student have a sibling at Al-Rushd? *

Any additional learning needs required for this student? *

Have you read the important message below? type yes/no

This section will ask for information about the person who is completing the form. All communication will be sent to the primary contact details you have provided. If you wish to add another contact to the students account you will be able to do so via your parental login once the registration process has been completed. Please complete all the mandatory fields. If you require any help, please contact Head Office on 02036330757.

Title *

First Name *

Surname *

Your Date of Birth

Email *

Primary Contact Number *

Relationship to Pupil *

Address (Please Include Town and County/State) *

Post Code/Zip Code *