Madinatul Ilm Academy Registration

Please fill in the following form with all the necessary details for your child to be added to our waiting list. A member of our staff will review the information and respond to you promptly.

* denotes required field

*Your name: (Parent/Guardian)

*Surname:

*Relation to student: Autofill: Father Mother Brother Sister

Type:

*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:

Email:

Enroll:

Normal Monday to Friday classes. 17:00-18:30 £40 per month.

Add medical info/notes

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:

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.

To proceed with the application, please tick the checkbox below and press Submit Application.

I consent that IBEUK can process this form and submit directly to Madinatul Ilm Academy. Your data will not be stored nor used by us.

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