Please fill the details student(s) to our waiting list. For more information, please contact us about this form.
* denotes required field
*Your name: (Parent/Guardian)
*Surname:
*Relation to student:
Autofill:
Father
Mother
Brother
Sister
Type:
SELECT ↵
Parent
Sibling
Emergency
Other
*Your email:
*Confirm email:
Parent Portal Password:
Confirm password:
If you already have an account and a password, you can skip this and leave it blank. Otherwise you should set your password now to login to the parent portal now.
Telephone:
*Mobile:
*Address:
*Postcode:
Students
Student #
1
:
Surname:
D.O.B:
Gender:
SELECT ↵
Male
Female
Email:
Add medical info/notes
Medical Conditions
General Notes
500
remaining
Allergies/Medical
(required)
Does your child have allergies/medical conditions?
Add Another Student
Contacts
You are the primary contact. You can add more contacts below.
Additional Contact #
1
Contact Name:
Email:
Tel.:
Parent Portal Password:
Confirm:
Mobile:
Alt. Mob.:
Relation:
Type:
SELECT ↵
Parent
Sibling
Emergency
Other
Primary Contact?
This means the contact will receive emails related to the student. The contact will also see the student on the parent portal to view progress and other information. If you select no here, this contact will not see the student on the parent portal.
Add Another Contact
I consent that IBEUK can process this form and submit directly to JMAH Madrasah. Your data will not be stored nor used by us.
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