London East Academy and Al Mizan School

London Muslim Centre (2nd floor)
46 Whitechapel Road,
London E1 1JX

Tel: 020 7650 3070

Email: admin@eastlondonmosqueschools.co.uk


Pre-Admission Information Request - Mosque / Madrasa

(to be filled out by Imam / Ustadh)

please enter student name
please enter the mosque

Please mark as appropriate:

1. Excellent  2. Very Good  3. Good   4. Satisfactory   5. Poor

Description Level Detail
Attendance
please enter the attendance level
please enter the details
Punctuality
please enter the punctuality level
please enter the details
Behaviour
please enter the behaviour level
please enter the details
Relationship with peers
please enter the relationship with peers
please enter the details
Relationship with staff
please enter the Relationship with staff
please enter the details
Motivation
please enter the Motivation
please enter the details
Academic Ability
please enter the Academic Ability
please enter the details
Moral Character
please enter the Moral Character
please enter the details
The above student is learning the Qur’an at this Mosque / Madrasa under me
select yes or no

He/She is able to read the Qu’ran accurately (sahih).
select yes or no

He/She has memorised Surah’s / Juzz(s)
please fill


I certify that the above student is enrolled with this mosque / madrasa.

Name of Imam / Ustadh:
please enter the name of imam / ustadh
Signature:
please enter the Signature
Date:
please enter the date

Seal / Stamp of the School

please fill the textarea