Forkania Education & Cultural Center

Student Details :

First Name

Sur Name

DOB

Post Code

Address

Parent/Guardian Details :

First Name

Sur Name

Occupation

Post Code

Mobile Contact

Address

Madrasah History :

(Please complete Question 1 if you are applying for Hifz class and likewise complete Question 2 for Nazirah class)

Last Madrasah Attended

- Number of Juz’/Parah Completed (Hifz Class)

Number of times Qur’an completed (Nazirah Class)

Kitab(s) Studied

Mark/Grade Achieved

Medical Details :

Name of Surgery

Name of Doctor

Surgery Contact Details

Please state any recent medication taken and allergies as well as any other relevant information:

Please provide any other relevant information that we may need to support the learning of your child(ren).

Other :