© Copyright UKIM Khizra Masjid. All rights Reserved. Powered by Pureii Interactive Media

School update details

School Update Details

For Parent/Guardian to complete: Child’s Surname
First Name(s)
Current supplementary school class name:
Current class teachers name:
Date of Birth
Gender
GirlBoy
Address
Postcode
Email
Tel no for parents
Mobile no
Names of Parent(s)/Guardian or responsible adult with whom my child lives
Language’s spoken at home
Allergies known
Medical illness and medicine taken
Name and address of primary/secondary school attended
Name and address of GP
Does your child suffer with learning difficulties and have special learning needs at school or home, please provide us with this Information
My child’s brother/sister already attends this school
YesNo
Name(s) of sibling & class
Name(s) of sibling & class
Name(s) of sibling & class
Name(s) of sibling & class

Emergency contact details

Name
Relationship
Address
Phone number
Mobile number
Name
Relationship
Address
Phone number
Mobile number
I confirm I will inform the office of any changes to the personal details of my child and have provided correct details whilst completing this form
I understand that it is my responsibility to cancel any standing order if the above named student leaves the school and any extra payment made due to failure to cancel the standing order will not be refunded. I confirm I will inform the office of any changes to the personal details of my child and have provided correct details whilst completing this form and I understand providing incorrect information is against the teachings of Islam.Confirm

Verification

Please enter any two digits *Example: 12
This box is for spam protection - <strong>please leave it blank</strong>: