Applicant Details: - Weebly

Application form 2011/2012

Madrasah Al-Hikmah GIRLS SCHOOL Bury Park Educational Institute

Girls School

Knowledge is the key to wisdom (Hikmah)

Applicant Details: Detail of Child: Forenames: …………………………..…….…..….

Surname: …..………………..…………..

Address: ………………………………………………………………………………………………..…………………… ………………………………………………………………………………………………….…………………. …………………………….………………………………………………………………….…………………… Post Code: ……………………………… Date of Birth:

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Telephone: …………………………………………….. Place Of Birth: ……………..…………….………….

Nationality: ………………………………… Current school: …………………..…………………. Applying for academic year: ………… Right of Permanent Abode in the U.K.:

Yes/no

Number of years lived in UK: ………..

Details of Parent/Guardian: First Name: ………………………………………… Surname: ……………………………………… Address (if different from above): ………………………………………………………………………………………………………..…………… ………………………………………………………………………………………………………..…………… ………………………………………………………………………………………………………..…………… Post Code: ……………………………..…

Telephone: …………………..……….………………

Mobile: ………………………………………….………… Nationality: ……………………………………………… Right of Permanent Abode in the U.K.:

Yes/no

Occupation: ………………………………………………………………………..

Madrasah Al-Hikmah, Bury Park Educational Institute 82-86 Dunstable Road, Luton, Beds, LU1 1EH, Telephone: (01582) 728196

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Emergency Contact Details: 1. First Name: ..……………….…………

2. First Name: ……………………..…………

Surname: ………………………..………

Surname: ………………………………………

Address: ……………………….………..

Address: …….………………………….………

……………….……………………..……….

……………………………………………………….

Post Code: .………….…….…………….

Post Code: .…………..………………..……….

Relation: ….…………….….………..…..

Relation: …….…………..…….………..……..

Home Tel: ……………….……..……….

Home Tel: ……….…………..…………………

Mobile: ………………….………………..

Mobile: ……………………..……………………

History: Previous School/Madrasah: ……………………………………………………………………………..... Address: …………………………………………………………………………………………………………… . …………………………………………………………………………. Postcode: ……………………………… Teachers name: …………………………………………….……… Tel: ……………………..…………….. Please state the reason for leaving your previous school: …………………………………………………………………………………………………………………………. . …………………………………………………………………………………………………………………………. . …………………………………………………………………………………………………………………………. .

Doctors Details: Name: ……………………………………………………….. Address: ………………………………………………….……………………………………………………… Madrasah Al-Hikmah, Bury Park Educational Institute 82-86 Dunstable Road, Luton, Beds, LU1 1EH, Telephone: (01582) 728196

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Application form 2011/2012 ………..…………………………………………………………………………………………………………..… Post Code: ……………………………………..…….

Telephone: ………….……….……………

NHS No: ……………………………………………….

Predicted SAT’s exam results (If applicable, please request from your current school): English: ………………..

Spoken Languages:

Mathematics/Numeracy: ……………….

Science: ……………….

Home Language: ……………….…… Second Language….…..…………..... Any other Languages: ……….…….………...

Qur’anic Knowledge: Are you able to recite the Quran from text?

Yes / no

If yes, how much of the Quran have you read so far? How much of the Quran have you memorised?

_____ Juzz / sipara.

_____ Juzz / surah.

General Islamic Knowledge:

What level of Islamic knowledge do you believe you possess?

Good/ Average/ Little.

Tell us a little more about yourself (hobbies/interests/skills etc.): ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………

Health details: Do you suffer from any serious long term illness? E.g. Epilepsy, Bronchitis, Asthma or allergies:

Yes/no

If yes, please give details of any such illness including medication: …………………………………………………………………………………………………………………………

Disability Information: (Please ask your current school for confirmation) Does your daughter suffer from any disability or is she registered disabled with the DfES? Madrasah Al-Hikmah, Bury Park Educational Institute 82-86 Dunstable Road, Luton, Beds, LU1 1EH, Telephone: (01582) 728196

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Application form 2011/2012 Yes / No

Does your daughter require Special Educational Needs (SEN)?

Yes / No

If Yes for any of the above two questions, please give details: ………………………………………….. ……………………………………………………………………………………………………………….. ….…………………………………………………………………………………………………………….. Have you ever been convicted of any criminal offence or any unsocial behaviour? Yes / No If yes, please give details of any such convictions: ………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………

Please state briefly as to why your child would like to join Madrasah Al-Hikmah and what she would like to achieve (optional): ……………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………

Please ensure you attach the following documents with your application failure to do so will delay the application: 1. Previous school reports (Most recent) 2. Medical Certificate from the GP 3. Birth certificate 4. Copies of your passport

Stages of application: 1. Approval of application by headteacher & space availability Madrasah Al-Hikmah, Bury Park Educational Institute 82-86 Dunstable Road, Luton, Beds, LU1 1EH, Telephone: (01582) 728196

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Application form 2011/2012 2. Satisfactory report from previous school 3. Interview with applicant 4. Acceptance of terms & conditions set by our school

Declaration: The information that I have provided are true to the best of my knowledge. I understand that if I have given any information knowingly which are incorrect then my application may be terminated. I have read and accept all the terms and conditions set by the school. All policies set by the school are for better education, safety and wellbeing of my child, and I will support the school in helping them establish these policies at all times.

Parent/Guardian Signature: …………………………………………

Date: ………………………………

For Office use only: All required documents are present Application Number.................................................. Date Received: ………..……………….......……….....by.......................................................... Signed: ………………………….................................. Application processed:..................................... Date of Interview:............................................................................. Successful Interview:....................................... Date of Admission:...........................................................................


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Notes For Parents/Guardians: Admission to the school is at the discretion of the headteacher and not to the Governing Body or Masjid Committee. The headteacher will take into consideration: If application and neccessary documents were given in due time Whether spaces are available The previous report of pupils A satisfactory interview

Please be aware that the number of applications we expect will exceed the number of places we have available (inshaAllah). To read the complete Admissions policy please visit our website: www.bpei.weebly.com Fees Fees for 2011/2012 have been set at £1700 for the year. There is a sibling discout (brother or sister ONLY) of £100. Fees can be paid as a lump sum, in termly installments or as monthly payments via cheque, cash or standing order, please note that falling behind on payments will result in administration charges of £10 per month. School Day The School starts at 1430 and finishes at 1950, girls must be collected by a Mahram after school, pupils will not be allowed to walk home on their own.

JazakAllah Madrasah Al-Hikmah, Bury Park Educational Institute 82-86 Dunstable Road, Luton, Beds, LU1 1EH, Telephone: (01582) 728196

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