Admissions Form

Fill out the application form below to apply for admission to the Unique Madrasah and Tuition Academy. Please fill out one form per child.

Child's Full Name (First Name and Surname)*

Date of Birth*

Gender*
MaleFemale

Course Selection (hold Ctrl key for multiple selections)

Address Line 1*

Address Line 2

Town*

Country*

Post Code*

Mother's Name*

Mothers contact number*

Father's Name*

Fathers contact number*

Main Correspondence Email Address*