Existing Student Electronic Data Enrolment Form

Student Details

Students age in years
Mobile or primary contact number
Home landline number if you have one, or alternate contact number
Please select your nationality
Please select your country of origin (where you born, if different from your nationality)

Course/Education

Please check the minimum age entry requirements for courses on the classes page of the Academy website before applying for any course

Emergency Contact

Mobile or primary contact number
Home landline number if you have one, or alternate contact number
Enter a work telephone number if you have one and may need to be contacted on it

Medical

Please enter your Dr's full name
Please provide the applicants NHS number if known
hereby give permission for the Islamic Academy of Coventry to give the immediate necessary authority on my behalf for any medical or surgical treatment recommended by competent medical authorities, where it would be contrary to my/my son/daughter’s interest, in the doctor’s medical opinion, for any delay to be incurred by seeking my personal consent. Note. Please note that a young person can give their own consent for medical treatment if they are over 16.

 

By selecting a choice you hear by give consent

Rules and Regulations

  1. All new applicants will have to pass the admission test.
  2. Disclosure of all previous character and conduct is necessary.
  3. It is necessary to attend all lessons.
  4. All Islamic Laws and regulations will have to be followed in all aspects of life particularly prayers, dress, social affairs, etc.
  5. To insult the trustees, teachers or staff of the Academy (verbally or physically) will be judged as inexcusable and any student found guilty of such behaviour will be liable for dismissal.
  6. The Academy reserves the right to expel any student when it deems necessary. Anyone expelled will have no legal remedy against the Academy.
  7. Any false information given will be liable for immediate dismissal.
  8. The student/parent/guardian will be held fully responsible for the cost of any damage to the property of Islamic Academy of Coventry.
  9. All the above rules and regulations will have to be adhered to fully.

Declaration

  1. The information I have given on the form is true and accurate to the best of my knowledge. I understand that my application will be disqualified if I have knowingly given false information.
  2. I have read or had explained to me and understand all the questions and rules and regulations on this form.
  3. I have read and accept to follow all the rules and regulations of Islamic Academy of Coventry.

 

By clicking submit you agree to the above terms and rules of the Academy

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