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Al Mizan School
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Online application form
Year 6 -7 Transition
Online application form
Please complete all fields marked (*)
Check List for Application Form
*
I have completed all sections of the form.
Pre-admissions forms (Madrasah / Quran Teacher & from child’s full-time school) completed
I the Parent/Guardian have signed the KS1 SATs (Primary) / KS2 SATs (Secondary) application form.
How did you hear about us?
Student Details
Student First Name(s) As In Birth Certificate
*
Last Name
*
Date of Birth
*
Age
*
Gender
*
Male
Female
Other
Year Group Required
Please select
*
Al-Mizan Primary School YEAR 3
Al-Mizan Primary School YEAR 4
Al-Mizan Primary School YEAR 5
Al-Mizan Primary School YEAR 6
Preferred Start Date
*
This Academic Year
Next Academic Year
Student Details
Full Address
Post Code
Telephone
Mobile
Ethnicity
Nationality
Religion
Languages spoken at home
Medical History (i.e. Asthma,Epilepsy and is the child taking any medication):
Is your child identified as needing SEN Support (Special Educational Needs Support)?
No
Yes
If yes please give details
Does your child have an EHCP (Educational Health Care Plan)?
Yes
No
If yes please give details
Has your child received any additional support in the last six months under SEN Support/Inclusion?
Yes
No
If yes please give details
Does your child have an Early Help Assessment (EHA) Plan?
Yes
No
If yes please give details
Has your child had contact with the Child and Family Service or Child and Adolescent Mental Health services (CAMHs)?
Yes
No
If yes please give details
Has your child been issued with a Child in Need (CIN) or Child Protection (CP) status in the last twelve months?
Yes
No
If yes please give details
Does your child have any other needs that we should know about?
Yes
No
If yes please give details
Does your child have any siblings currently attending our schools?
Yes
No
If yes, please state name(s) and year group(s)
CURRENT EDUCATION
School Name
Full Address
Post Code
Telephone
E-mail
Teacher
Head Teacher
Year Group
Evening/weekend Madrasah Attending
Madrasah Address
Madrasah Teacher
Madrasah Head Teacher
Parent/Carers
Name of Father (or Carer)
Father's Full Address (If different to above)
Father's Post Code
Father's Telephone
Father's Mobile
Father's Email
Father's Occupation
Father's Telephone(work)
Name of Mother(or Carer)
Mother's Full Address(If different to above)
Mother's Post Code
Mother's Telephone
Mother's Mobile
Mother's Email
Mother's Occupation
Mother's Telephone(work)
EMERGENCY CONTACTS (Two Contacts Required)
Name
Emergency Contact 1 - Full Address
Emergency Contact 1 - Post Code
Emergency Contact 1 - Telephone
Emergency Contact 1 - Relationship to child
Emergency Contact 2 - Name
Emergency Contact 2 - Full Address
Emergency Contact 2 - Post Code
Emergency Contact 2 - Telephone
Emergency Contact 2 - Relationship to child
Statement Of Reason For Application - Parent
Why do you want your child to attend this school?
Statement Of Reason For Application - Child
Why do you want to attend this school?
PRELIMINARY AGREEMENT
I understand that all children must adhere strictly to schools' code of conduct and values at all times.
As a parent/carer, I agree to follow the schools rules and regulations on all matters related to the school.
I will follow due protocols for suggestions and complaints.
I will pay for any damages caused by my child during his/her attendance at school.
I will endeavor to adopt any home-school support structure to assist the applicant in developing Islamic adhaab & aklaq as well as their academic progress.
I confirm that the information given above is correct to the best of my knowledge and that if any information changes, I will notify the school immediately.
Your Full Name
Relationship to Child
Date
Please provide a signature.
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