IANL Academy Registration Form

Register for Jan 2021 Term


    Pupil Information













    Pupil's current school year



    What class are you enrolling the child for



    What languages does the child know?



    Does the Pupil have any special needs, or any allergies / medical conditions? If so, please elaborate and complete the additional Medical Information Form



    Name of other siblings in IANL Academy



    Please provide previous Islamic education experience. (i.e. None, Started Qaidah, Completed Qaidah, Can read Quran etc). For Hifdh applicants: insert number of Juz memorised & previous Institution Details (if memorised at home with parent, please mention this)



    Parent/Guardian 1






    Yes


    Enter address if different













    Parent / Guardian 2






    Yes


    Enter address if different











    Is this parent/guardian an emergency contact. If not an emergency contact can be provided below.

    Alternate Emergency Contact: