Asr Academy

Student – Personal Details

Name*

First Middle Last

Date of Birth*

Age

Gender*

Student – Contact Details

Address*

Street Address Address Line 2 City ZIP / Postal Code Country

Email*

Home / Mobile Number*

Additional Details

School Name*

School Year Group*

Does your child have any Special Education Needs [SEN] or receive any Educational Support currently in school ?

Yes

Please provide details relating to SEN or additional learning support provided to your child

General Notes

Medical Notes

Additional Questions

Why would you like to join the programme?*

[Limit to 100 words]

Bank Details for Payment

Please pay £250 by bank transfer to the following details and use the reference ‘AsrAcademy’. Once this is done, please send a confirmation of payment by email to asracademy@madressa.net to complete your application.
Bank Name: Barclays
Account Name: S I Madressa
Account Number: 90843970
Sort Code: 20-29-37
Reference: AsrAcademy

Parent / Guardian – Personal Details

Name*

First Last

Relation*

KSIMC Membership Number*

If you do not have a membership number please type 0000 in this box

Do you work with children?*

Yes

Occupation

Are you a school governor?*

Yes

If yes, please provide the name of the school

Madressa Photo & Video Policy Consent

The Madressa has a ‘Use of Images’ policy in line with its Safeguarding commitments in order to provide a greater understanding on how images will be handled and what boundaries are in place for Madressa events.

This policy will govern how the Madressa will handle matters relating to photography and video on the Madressa premises.

Occasionally, we may take photographs of the children at our Madressa. These images may be used in our Madressa printed publications that we produce, on our website, or on project display boards. We may also make video recordings for monitoring or other educational use.

To review our full policy, please click here

May we use your child’s photograph in printed publications that we produce for promotional purposes, or on project display boards, etc?*

Yes

May we allow your child to appear in the media as part of our Madressa's involvement in an event?*

Yes

May we use your child’s image on our Madressa Website?*

Yes

May we use child's image on video?*

Yes

Policy Agreement

By clicking ‘Register’ you also agree to our:

Admission and Attendance policies.
Privacy notice which outlines how we will use the data you have provided to us for Madressa purposes only All other policies that are either posted on our website www.madressa.net, provided in writing or communicated through other means.
If my child is aged 13 or over, I have consulted him / her on how the Madressa will utilise their data and they have provided consent for Madressa to use their data.

Comments

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