Enrolment Form Course (required) ---Full-time AlimiyyahHeirs of the ScholarsDiplomaFull-time Hifdh Year of Study (required) Please provide your contact details Full Name (required) Gender (required) ---MaleFemale Address (required) City (required) Postcode (required) Age (required) Mobile Number (required) Landline Number (required) E-Mail Address (required) Are you in full-time education? (required) ---NoYes Please provide information of two individuals who are your next of kin in case of emergency Contact 1: Relationship (required) Contact Number 1 (required) Contact Number 2 E-Mail Address (required) Contact 2: Relationship (required) Contact Number 1 (required) Contact Number 2 E-Mail Address (required) Contact 1 (Father): Contact Number 1 (required) Contact Number 2 E-Mail Address (required) Contact 2 (Mother): Contact Number 1 (required) Contact Number 2 E-Mail Address (required) Have you taken part in any Islamic Studies before? (required) ---YesNo If yes, please provide the course name, institute and the duration of your studies Medical Conditions/Allergies Have you got any medical conditions or allergies we should be aware of in case of an emergency? (required) ---YesNo If yes, please provide further information below Refund Policy Once you have enrolled and your form has been processed, the enrolment fee is non-refundable. Once you have attended your first lesson, your first monthly fee is non-refundable. Any book that has been used or written on is non-refundable. Agreement and Signature I affirm that the information set forth in this form is true and complete. I understand that if I am enrolled on to any As-Suffa Institute course, any false statements, omissions, or other misrepresentations made by me on this form may result in my immediate dismissal as a student. I also understand that by becoming a student I am accepting that As Suffa Trust takes no liability for any loss of possession, any injuries or loss of life. As-Suffa Institute may use this information to provide and enhance our services. We may use your contact details to send newsletters, messages about our activities, project updates, special offers, promotional announcements, surveys and other correspondence and marketing concerning our services. As-Suffa Institute will not share your details with any third party. If you wish to opt-out of this service please tick this box. The information given on this form will be held and processed in compliance with the Data Protection Act. Please carefully read the Privacy Statement and rest assured your details will be administered in compliance with GDPR regulation. The views and opinions expressed on the students/class social media pages do not necessarily represent those of As-Suffa Trust. Therefore, we cannot be held responsible for the accuracy or reliability of information posted by external parties. Please carefully consider opting in to students/class social media pages as you will be doing so at your own risk.