Admission Form

Child's Details

Date of Birth *

Date of Birth

Gender *

First Name *

Surname *

Address *

Postcode *

Preferred choice of name if any

Application For *

Funding

Funding?

Name of 1st Parent/Guardian Living at Home Address Above

Title *

First Name *

Surname *

Relationship to Child *

Parental Responsibility *

Date of Birth *

Date of Birth

Home Telephone Number *

Mobile No. *

National Insurance Number

Work Telephone Number *

Work Place *

Name of Second Parent/Guardian

Title

First Name

Surname

Relationship to child

Parental responsibility?

Date of Birth *

Date of Birth

Mobile phone number

Work telephone number

National Insurance Number

Address (if different)

Work place

Other children in the family name(s) and date of birth

Emergency Contact Details

Name of doctor *

Telephone number *

Practice address *

Post code *

Name(s) *Other local contacts in case of emergency or illness at school

Telephone number *

Your child will be placed on the waiting list and contacted when a place becomes available.

Thank you for telling us about your child, we look forward to your child joining us and enjoying their time at Dar ul Madinah Slough

Declaration

I confirm all the details completed in this form are true and accurate. I will inform Dar ul Madinah of any changes immediately.

Sign *

Date *

Print Name *

Parent/Career

Any information given to the pre-school as part of this application/registration form will be treated with the strictest of confidence. Any Data collected will be, fairly and lawfully processed, for limited purposes, adequate, relevant and not excessive, accurate, not kept longer than is necessary, processed in accordance with the data’s subjects rights, held securely and not transferred to other organizations unless required to do so by Ofsted, health and safety legislation or other legal obligations.

Admission Form

Child's Details

Funding

Name of 1st Parent/Guardian Living at Home Address Above

Name of Second Parent/Guardian

Emergency Contact Details

Your child will be placed on the waiting list and contacted when a place becomes available.

Thank you for telling us about your child, we look forward to your child joining us and enjoying their time at Dar ul Madinah Slough

Declaration

I confirm all the details completed in this form are true and accurate. I will inform Dar ul Madinah of any changes immediately.

Contact info

Information

Account