LONDON EAST ACADEMY & AL MIZAN SCHOOL

ISLAMIC SECONDARY SCHOOL FOR BOYS & ISLAMIC JUNIOR SCHOOL
London Muslim Centre
46 Whitechapel Road, London, E1 1JX
Tel: 0207 650 3070
Text: 07903 590 479
admin@eastlondonmosqueschools.co.uk
www.eastlondonmosqueschools.co.uk

APPLICATION FORM

Check List for Application Form

Please ensure all the boxes are ticked before you submit the form to school's office.


Please check the box
Please check the box
Please check the box
Please check the box
Please check the box
Please Enter the Aboutus box

STUDENTS DETAILS

Please Enter the First Name

Please Select the Date of birth

Please Enter the age
Please Enter the Last Name


Select Male or Female

YEAR GROUP REQUIRED

Please Select Year


Select Academic Year

PRELIMINARY AGREEMENT

(If the applicant is taken as a student at the schools)

  1. I understand that all children must adhere strictly to schools’ code of conduct and values at all times.
  2. As a parent/carer, I agree to follow the schools rules and regulations on all maters related to the school.
  3. I will follow due protocols for suggestions and complaints.
  4. I will pay for any damages caused by my child during his/her attendance at school.
  5. I will endeavor to adopt any home-school support structure to assist the applicant to develop Islamic adhaab & aklaq as well as their academic progress (should the applicant be found needing extra support).
  6. I confirm that the information given above is correct to the best of my knowledge and that if any information changes, I will notify the school immediately.
Please note that the school does not disclose test results

Parents / Carers are to sign a full agreement before a child takes his/her place.

DECLARATION BY PARENT / CARER:

Please Enter the Full Name

Please Enter the Relationship
Please Enter the Signature

Please Select the Date

Entry to each year group has varying entry requirements. Please read the NOTES AND GUIDANCE sheets available separately to get a detailed view of criteria. If you have any difficulties or want to discuss with someone about the application procedures,Please do not hesitate to call or email the school's office.


PARENT/CARER

Please Enter the Father Name
Please Enter the Address

Please Enter the Postcode
Please Enter the Telephone

Please Enter the Mobile No
Please Enter the Email

Please Enter the Occupation
Please Enter the Telephone(Work)

Please Enter the Mother Name
Please Enter the Address

Please Enter the PostCode
Please Enter the Telephone

Please Enter the Mobile
Please Enter the Email

Please Enter the Occupation
Please Enter the Telephone(Work)

EMERGENCY CONTACT (Two Contacts Required)

Please Enter the Name
Please Enter the Name

Please Enter the Address
Please Enter the Address

Please Enter the Postcode
Please Enter the Postcode

Please Enter the Contact No
Please Enter the Contact No

Please Enter the Relationship
Please Enter the Relationaship

STATEMENT OF REASON FOR APPLICATION (Parent/Carer Should Write Here)

Please Enter the Statement

STATEMENT OF REASON FOR APPLICATION (Applicant Should Write Here)

Please Enter the Statement

STUDENT DETAILS

Please Enter the Address
Please Enter the Post code

Please Enter the Telephone
Please Enter the Mobile

Please Enter the Ethnicity
Please Enter the Nationality

Please Enter the Religion
Please Enter the Language

Please Enter the Medical History

Please Select the Option


Please Select the Option


CURRENT EDUCATION

Please Enter the School Name
Please Enter the Address

Please Enter the Postcode
Please Enter the Telephone

Please Enter the Email
Please Enter the Teacher

Please Enter the Head Teacher
Please Enter the Year Group

Please Enter the Attending Time
Please Enter the Current Address

Please Enter the Post Code
Please Enter the Teacher

Please Enter the Head Teacher