Madrassah Application Form
Maktab, Hifdh Class,Islamic Studies and Arabic Language
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 Maktab Policy, Term and Condition
Before filling out the application form, please click on the link to review the Maktab Policy and Terms and Conditions.
Child's First Name *
Child's Middle name
Child's Surname *
Gender *
Date of birth *
Enter child date of birth (Separate by / )
MM
/
DD
/
YYYY
First Line of Your Address  Including Your Door Number *
Please enter first line of your address  including your door number
Second Line of Your Address
Optional
Post Town *
Pick your Post Town
City *
Enter City
Post Code *
Enter Post Code
Landline (put mobile if you do not have landline)
Enter Landline Number [IGNORE IF YOU DO NOT HAVE IT]
Mobile Number Mum *
Enter your Mobile Number  [NO SPACING BETWEEN NUMBER]
Mobile Number Dad *
Enter your Mobile Number  [NO SPACING BETWEEN NUMBER]
Email Address: *
Enter email address
Parental responsibility *
Medical or Learning Difficulty Details *
If your child suffers from any medical conditions, behaviour issues, or learning difficulties,
If Yes
Please give details If your child suffers from any medical conditions, behaviour issues, or learning difficulties,
Are you applying for *
Session one Mon 5-7pm, Wed 5-7, Fri 5-6 | Session two Tue 5-7, Thu, 5-7, Fri 6-7 | Sunday 10am to 2pm (Subject to Availability)
Do you have other children currently enrolled in Madrasah? *
Please tell us any children of your already in Maktab
If Yes
Please enter all children name below
Who will Drop and Pick up your Child *
Please select who your child will travel with, to and from Madrasah
If other than parents who will pick up and drop
Please specify below:
Parent or Guardian Name: *
Enter  name parent or guardian:
Relationship to child *
Enter  parent or guardian relations
Has your child completed Nazirah (recital) of the Qur’an? *
Has your child memorised any surahs/juz of the Qur’an? *
If Yes, which surahs/juz
Has your child taken any lessons in Tajweed? *
In the unlikely event of illness or accident I give permission for any necessary emergency first aid or medical treatment to be given. In an emergency and if I am not contactable, I am willing for my child to receive hospital treatment. I understand that every reasonable effort will be made to contact me as soon as possible
Clear selection
Photograph and video consent
I consent to my child appearing in photographs/videos for the following Maktab use. Please tick either Do or Don't for each option.
I give permission to take photographs and or video of my child
Clear selection
I give permission to put my child's photographs and or video On the Maktab Website, Prospectus and Social Media
Clear selection
I agree to my contact details being held in the HHMCT communication system
Clear selection
Declaration
I have read the above Maktab Policy, Term and Condition. I here by agree to abide by the Rules and Regulations of the Maktab, also have clear knowledge of General data Protection Regulation (GDPR) of Higham HIll Maktab and I undertake the responsibility to bring and collect my child at the appointed times and pay the correct fee per month per child.

• Fees must be paid during absence, as the child’s place will be kept reserved.
• Fees must be paid in one month advance.

By signing this form you are fully agreed to the terms & conditions of Higham Hill Maktab.
How did you heard about us *
Declaration *
Please select option YES  if you are agree No if disagree
Submit
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