Surname
First Name(s)
Date of Birth
Gender MaleFemale
Nationality
Name and Level of siblings currently attending MaktabZA?
Name of siblings currently on the waiting list of MaktabZA?
Current Address
Name of School
State if the Child Suffers from any Particular Ailment or Disease YesNo
Details, if Yes
Special Precautions (If Any)
Home Tel
Mobile
Whatsapp Number
Father Email
Mother Email
Capacity FatherMotherGuardian
Contact Person in Case of Emergency
I, the undersigned parent/guardian of the student, hereby absolve MaktabZA, its Online Madrasah, or any person employed by the Centre from all liability for any loss of property, damage, or data arising during the course of the student’s enrolment and participation in the Online Madrasah programs.
