Chadwell Heath Maktab Application Form
Complete the application with your details, your child’s information, and emergency contacts.
Parent/Guardian Information
Parent/Guardian Full Name
*
Phone Number
*
Email Address
*
Child Information
Child's Full Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Boy
Girl
Learning Information
Can your child read the Qur'an?
*
Yes
A little
No
Has your child attended a Maktab before?
*
Yes
No
If yes, where?
Medical & Emergency
Does your child have any medical conditions, allergies, or additional needs we should be aware of?
Emergency Contact Name
*
Emergency Contact Number
*
Agreement
I understand that places are limited to 14 students per class and are allocated on a first come, first served basis.
*
I understand.
I confirm that the information provided is accurate.
*
I confirm.
Please note: Each class is limited to 12 students, and places will be allocated on a first come, first served basis. Submission of this form does not guarantee a place until your registration has been confirmed.
Submit Application
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