— Enrollment

Enrollment application

Please complete one application per student. Fields marked with * are required. All information is kept confidential and used only for enrollment purposes.

1. Student details

Legal first name *Middle nameLegal last name *Preferred nameDate of birth *GenderYear level applying for *Intended start termIntended start yearCountry of birthLanguages spoken at homeCurrent school (if any)

2. Parent / guardian 1

Primary contact for the application.

Full name *Relationship to student *Mobile number *Email *Occupation

3. Parent / guardian 2

Optional.

Full nameRelationship to studentMobile numberEmailOccupation

4. Residential address

Street address *Suburb *State *Postcode *Country *

5. Emergency contact

Someone other than guardian 1, if possible.

Full nameRelationship to studentMobile number

6. Medical & learning support

Leave blank if not applicable.

Medical conditionsAllergiesRegular medicationsLearning support needs

7. Quran & Islamic studies background

Quran memorisation levelArabic reading abilityPrevious Islamic school / madrasah

8. Declaration

How did you hear about us?

Anything else we should know?I confirm the information provided is true and accurate, and I consent to NextGen Academy contacting me about this application. *