Maktab Application Details

Admission Year (required) —Please choose an option—2026/2027 Year Group Applied For (required) —Please choose an option—Year 1 (age 5/6)Year 2 (age 6/7)Year 3 (age 7/8)Year 4 (age 8/9)Year 5 (age 9/10)Year 6 Boys (age 10-11)Year 7 (11-12)Year 6 Girls (age 10-11)Year 7+ Girls (age 11+)Hifz 1 (Boys aged 11-13)Hifz 2 (Boys aged 14-16)

A. Child Details

Child First Name (required) Child Surname (required) Date of Birth (required) Faith (required) —Please choose an option—MuslimRevert Muslim Gender (required) —Please choose an option—MaleFemale Current Home Address (required) Postcode (required) Home Telephone (required) First Language (required) Other Languages Spoken at Home

B. Parent / Carer Details

Provide details for all adults with parental responsibility where possible. Parent/carer 1 should be the main contact unless stated otherwise. Parent/carer 1's details below will also be used as the signatory on the declaration at the end of this section.

Parent/Carer 1

Full Name (required) Relationship (required) Address (leave blank if same as child) Faith —Please choose an option—MuslimRevert Muslim Mobile (required) Email (required) Parental Responsibility? (required) —Please choose an option—YesNo

Parent/Carer 2

Full Name Relationship Address (leave blank if same as child) Faith —Please choose an option—MuslimRevert Muslim Mobile Email Parental Responsibility? —Please choose an option—YesNo Who does the child normally live with? (required) Main Contact for Maktab Communications (required) Are the above parents married and living together? (required) —Please choose an option—YesNo

C. Emergency Contacts

Please provide at least two emergency contacts where possible.

Emergency Contact 1 (required)

Full Name (required) Relationship (required) Mobile (required) Alternative Phone Can Collect Child? (required) —Please choose an option—YesNo

Emergency Contact 2 (required)

Full Name (required) Relationship (required) Mobile (required) Alternative Phone Can Collect Child? (required) —Please choose an option—YesNo

Emergency Contact 3

Full Name Relationship Mobile Alternative Phone Can Collect Child? —Please choose an option—YesNo

D. Admissions Criteria / Eligibility

Sibling(s) already at the Maktab? (required) —Please choose an option—YesNo

E. Previous Education (if applicable)

Previous Maktab Name Previous Maktab Address Previous Maktab Contact Phone/Email Dates Attended (From MM/YY – To MM/YY) Reason for Leaving / Transfer Any Additional Information to Support Your Child

F. Medical, Allergy and Welfare Information

GP / Surgery Name (required) Doctor's Name GP / Surgery Telephone Any Medical Conditions? (required) —Please choose an option—YesNo Any Allergies? (required) —Please choose an option—YesNo Medication Required in Maktab? —Please choose an option—YesNo Dietary Requirements Emergency First Aid Consent (required) —Please choose an option—YesNo

G. SEND, Learning, Language and Pastoral Support

Is there an Education, Health and Care Plan (EHCP) for your child in school? —Please choose an option—YesNoIn progress Does your child have SEND or learning support needs? English as an Additional Language? —Please choose an option—YesNo Does your child have any visual impairments? Does your child require Pastoral, Wellbeing or Behaviour Support in School?

H. Safeguarding and Collection Arrangements

Adults Authorised to Collect the Child (required)
Please list: Full Name – Relationship – Contact Number for each person People NOT Authorised to Collect the Child Court Orders / Legal Restrictions Affecting Contact or Collection? (required) —Please choose an option—YesNo Safeguarding Information the Maktab Should Know

I. Permissions and Consents

Emergency First Aid and Medical Support (required) —Please choose an option—YesNo Notes Local Walking Trips / Routine Local Visits (required) —Please choose an option—YesNo Notes Internal Maktab Photos/Videos for Learning Records and Displays (required) —Please choose an option—YesNo Notes External Photos/Videos for Website, Newsletter, Social Media, or Marketing (required) —Please choose an option—YesNo Notes Email/SMS/Phone Communication (required) —Please choose an option—YesNo Notes WhatsApp or App-Based Communication, if used by the Maktab (required) —Please choose an option—YesNoN/A Privacy Notice Received and Understood (required) —Please choose an option—YesNo

J. Documents Checklist

Please note you will be asked to bring the following in when requested:

Birth certificate or passport / proof of date of birthProof of address (Parent and Child)Medication form, if applicableCourt order / legal document, if applicable

K. Parent / Carer Declaration

By submitting this form, Parent/Carer 1 named above confirms the information provided is accurate to the best of their knowledge, and agrees to notify the school promptly if any contact, medical, safeguarding, or consent information changes. This declaration is also covered by the agreement checkbox at the end of this form.

Signature (type name to confirm) (required) Date (required)

Course Year of Study (required) —Please choose an option—12345678

How many modules do you want to enrol for? (required) SelectTwoFour

Module 1 (required) Tafseer (Tuesday AM)Tajweed (Tuesday PM)Fiqh (Thursday AM)Hadeeth (Thursday PM) Module 2 (this cannot be the same as module 1) (required) Tafseer (Tuesday AM)Tajweed (Tuesday PM)Fiqh (Thursday AM)Hadeeth (Thursday PM)

School year (required) —Please choose an option—Year 7Year 8Year 9Year 10Year 11Year 12Year 13

Please provide your contact details

Full Name (required) Gender (required) —Please choose an option—MaleFemale Address (required) City (required) Postcode (required) Age (required) Mobile Number (required) Landline Number (required) E-Mail Address (required) Have you taken part in any Islamic Studies before? (required) —Please choose an option—YesNo

Medical Conditions/Allergies

Have you got any medical conditions or allergies we should be aware of in case of an emergency? (required) —Please choose an option—YesNo