Admission Form (Step 1) | Rawdat al-Quran al-Kareem

STUDENT INFORMATION

First Name*

Middle Name*

Surname*

Date Of Birth*

Hijri Date Of Birth*

Place Of Birth*

ITS No.*

Citizenship*

Gender* MaleFemale

Residential Address

Communication Address

(Please indicate the address to which you would want the Institute to send communication.)

Language Spoken at Home*

Other Languages Spoken*

Emergency Contact

Proceed To Next

Other Schools Attended

Grade (s)*	School Name*	Location (city/country)*	Language of Instruction*	Dates Attended month and year*
				From To
				From To
				From To

Does your child have any special learning needs? YesNo
Has your child ever received any specialized instruction, i.e. Speech therapy, remedial reading support, special YesNo
Is your child physically challenged? YesNo

If “Yes”, please describe

Name of current school*

Name of Principal*

School Phone*

School address*

Hifz Details*

Has your child memorized any Surahs from the Quran? YesNo

For Parents*

Proceed To Next

FATHER INFORMATION

First Name*

Middle Name*

Surname*

ITS No.*

Home address (if different from Applicant’s)*

Mobile no*

Email*

Name of company or Idara and position*

Business address*

Business telephone*

Email*

Schools, colleges attended*

Annual Income:* Below 5 LakhsBetween 5-10 LakhsAbove 10 Lakhs

MOTHER INFORMATION

First Name*

Middle Name*

Surname*

ITS No.*

Home address (if different from Applicant’s)*

Mobile no*

Email*

Name of company or Idara and position*

Business address*

Business telephone*

Email*

Schools, colleges attended*

Proceed To Next

GUARDIAN INFORMATION

First Name

Middle Name

Surname

ITS No.

Home address (if different from Applicant’s)

Mobile no

Name of company or Idara and position

Business address

Business telephone

Schools, colleges attended

DETAILS OF APPLICANT'S SIBLINGS

Name*	Male/Female*	Birth date*	School*	Standard*