MADRASATI REGISTRATION

(*) REQUIRED

Email Address *

Child's Name *

Child's Gender * Select Gender Male Female

Child's MYKID / Birth Certificate / Passport No *

Enter child's position in the family * Position 1 2 3 4 5 6 7 8 9

Child's Date of Birth *

Child's Age * Select Age 6 7 8 9 10 11 12 13

Address *

Contact Number *

Programme * PRIMARY 9:00 AM TILL 3:30 PM PRIMARY 9:00 AM TILL 5:30 PM PRIMARY SPECIAL NEEDS KAFA

Does your child have any special needs ? * Special Needs YES NO

Allergies and Medical History

Has your child went to any other school or kindergarten * YES NO

Previous School *

Why did you choose Madrasati?

How did you find out about Madrasati? *

Is transportation needed? YES NO

Father's Name *

Father's Contact *

Father's Occupation

Father's Work Address

Father's IC Number *

Mother's Name

Mother's Contact

Mother's Occupation

Mother's Work Address

Mother's IC Number

I hereby declare that the information provided is true and correct to the best of my knowledge. I agree to abide by the regulations set by Sekolah Rendah Integrasi Islam Madrasati for my child's interest * YES NO

Signature *