HRW ISLAMIC INSTITUTE

MADRASSATUS SAALIHEEN

92 Kastaiing Street, Weltevreden Park

MadrasahEnrolment Form

TO BE COMPLETED BY ALL LEARNERS ATTENDING THE INSTITUTE FOR 2018

Please indicate number of children attending from same family:

  1. New Learners to complete all sections. One form per child.
  2. Learners that were with the Madrasah in 2017 to exclude Section B but complete Section A. Section C to be filled only if any changes are applicable, ID copies need not be attached again.
  3. Page 3 to be kept and Page 4 to be signed and re-attached.

Madrasah commencement date: 17 January 2018

SECTION A

Student Information

Name
Surname
Age
ID No:
* Please attach copy
Date of birth
School currently attending & grade

SECTION B

Islamic Educational Information

Last institute attended
Last class passed(attachreport
Reference – Aalim/a

Detailed Information

Subjects completed / Kitaabs completed per subject
1.
2.
3.
4.
5.
6.

MadrassatusSaaliheen

Enrolment Form – page 2

Quraan Recital Proficiency (Please indicate level by marking with “X”

None
Beginner
Intermediate
Advanced

Memory of Surahs - Please indicate surahs memorized to date (from – to)

SECTION C

Parent / Guardian Information

Father Mother

Name
Surname
Occupation
Work contact no.
Home contact no.
Cell no.
Email
Residential address

Next of kin

Name
Surname
Relationship
Work contact no.
Home contact no.
Cell no.
Email

Medical Information - Allergies please specify:

Please specify any medical conditions or special needs that the institute should be aware of:

MadrassatusSaaliheen

Enrolment Form – page 3

Terms of Admission

1) Fee Structure

R1040per term per child.

If >1 child, R1040 for 1st child, R680 for 2nd child and R330 for 3rd child where applicable

A separate form must be completed for each child

No children below the age of 6 will be accepted by the Madrasah unless they are also commencing grade 1 at school and on condition that the child turns 6 before June.

There is a private Nursery Madrasah in the area. Contact Sister MashoodaCoovadia for further information on 076 917 9544.

Fees are payable within the 1st week of the new term into our bank account as specified below.

HRW Islamic Institute

First National Bank

Acc No: 622130 86714

Branch: 251141

Ref: Initials / Surname / Class – example MKaraC4

While cash will be accepted, it is the preferred that fees are paid via EFT.

Fees exclude the costs of kitaabs, stationery, extra activities and excursions.

2) Rules

I, the undersigned as parent / guardian of the above child, hereby apply for the admission of the above child to the above institute and hereby agree to abide by the rules and regulations of the institute;

I agree to hold myself responsible for any damage/s that may be caused to any property by the above child;

I fully understand and accept that all activities undertaken will be at the child’s own risk and I undertake on behalf of myself, my executors, my spouse and my child/rento indemnify and hold harmless the above institute, its staff, management structure, shareholders, employees and all related parties from any or all claims whatsoever that may arise in connection with any injury sustained by the child in the course of any activities undertaken or in the course of attendance to the institute. I further, indemnify and hold harmless the above institute, its staff, management structure, employees and all related parties from any or all claims whatsoever that may arise in respect of any loss/es sustained or any property damaged;

I am obliged to pay the full fees as detailed above failing which the institute reserves the right at its discretion to cancel my child’s attendance by written notification to any of the contact details indicated on this form;

In the event that my child is suspended or expelled by the Institute for reasons deemed appropriate at the discretion of the Institute, I will have no recourse legal or otherwise to any juristic or Islamic body other than the Institute itself or the Jamiat of which the Institute is an affiliate of.

Times: 3-5pm Monday to Friday

A Code of Conduct will be issued at the beginning of the year.

MadrassatusSaaliheen

Enrolment Form – page 4

I have read and understand the conditions above and accept all rules and regulations of the institute and hereby agree to abide to these and be bound where required.

Name
Date
Place
Signature

MadrassatusSaaliheen

Enrolment Form – page 4

I have read and understand the conditions above and accept all rules and regulations of the institute and hereby agree to abide to these and be bound where required.

Name
Date
Place
Signature

MadrassatusSaaliheen

Enrolment Form – page 4

I have read and understand the conditions above and accept all rules and regulations of the institute and hereby agree to abide to these and be bound where required.

Name
Date
Place
Signature