Student Admission Form

First Name *

Last Name *

Email *

Phone *

Home Address *

Postal code *

Choose which centre you want to attend *

Hounslow jamia mosque ( Saturday 11:00 am to 13:00 pm)

Name of Your School *

Date of birth *

Gender *

Upload Your Picture

Do you have any medical conditions / disability or special needs?

Parent's / Emergency Contact *

Email

We would be grateful if you would fill in this form to give us permission to take photos of your child and use these in our printed and online publicity. Your data will always be use according to GDPR guidelines.

I give permission to take photographs and / or video of my child.

Yes

No

I give permission to the SI Foundation to use my data for administrative and marketing purposes.

Yes

No

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.