NON MTQ Alimiyyah Form Non MTQ Pupils Admission Form This form is to be filled in for pupils NOT studying at Al-Ansaar Welfare & Education Please read our pre-admission information before filling in an online application form as it contains a lot of important information Alimiyyah | Pre-Admission Information PART 1Pupil Name* Forename(s) Surname Date of Birth* DD slash MM slash YYYY Parent's Full Name* Mother Father Address* House Number & Street/Road City Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Tel (Home)*Mobile (Mum)*Mobile (Dad)*Email (Mum)* Enter Email Confirm Email Email (Dad)* Enter Email Confirm Email PART 2I have attended the “new parents’ information session.* Yes No N/A Tick all applicable.* I understand the length of the Alimiyyah course. I am aware of daily timings and also Saturday mornings. My son is happy to enrol on the Alimiyyah course. How old will your son be on 1st September* Age PART 3This child has involvement with Social Services.* Yes No This child is statemented (SEN).* Yes No This child receives extra support in school.* Yes No This child has been excluded from school / Madrasah in the last 2 years.* Yes No PART 4Name of Madrasah* How long has your child been at this Madrasah?* Tajweed Studied?* Yes No Arabic – Any previous learning?* Yes No School Education* Name of High School Which year is your child in? References Name of Teacher 1* First Last Email (Teacher 1)* Enter Email Confirm Email Mobile (Teacher 1)*Name of Teacher 2* First Last Email (Teacher 2)* Enter Email Confirm Email Mobile (Teacher 2)*Any other information relevant to this admission request:Declaration:* I have filled in this admission to the best of my knowledge, if I have not attended the “new parents’ information session”, I will attend the next one. I have received and read the Pre-Admission Guidelines for Alimiyyah class. GDPR Clause I grant The Suffah Institute permission to store personal details submitted on the form. I consent to The Suffah Institute storing these details for all administrative purposes.CAPTCHA Δ
