Al-Buraq Education Programme

Our Al-Buraq Education Programme is now open.

If you are interested in enrolling your child, please fill in the form.

Please select which year you are applying for

Child's First Name

Child's Surname

Child's Date of Birth

Child's Age

Child's Gender

Full Address

Ethnic Origin

Nationality

Is there a disability / allergy / serious condition / learning difficulty which we need to know? You must provide this information for us to help your child progress. Please give FULL details. If NONE then please state NONE

Please tick if any of the following are applicable:

Has the child been involved with any kind of Social Services Is the Child Statemented (SEN - Special Education Needs) Has the Child attended or is attending speech therapy None of the above

Is the child currently attending or has attended another Madrassah for Islamic Education?

Yes No

If Yes, please state which Madrassah:

Father's Full Name

Father's Occupation

Father's Email Address

Father's Mobile Phone Number

Father's Address (if different from child)

Mother's Full Name

Mother's Occupation

Mother's Email Address

Mother's Mobile Phone Number

Mother's Address (if different from child)

Home Phone Number

Any additional comments

Do you have any other children currently studying at Al-Buraq Masjid?

Yes No

Name of sibling currently studying at Al-Buraq Masjid

Disclaimer:

I confirm I have entered the correct information and accept all of the Policies

Email Address