Register Student – Arabiya School Derby

info@arabiyaschoolderby.org
07934521847

Parent/Guardian Details

Parent's Name (English) *

First

Last

Parent's Name (Arabic) *

First

Last

Mobile Number *

Home Number

Email *

Address

Address Line 1

City

State / Province / Region

Postal Code

Emergency Contact

Full Name *

Phone Number *

Relationship *

Students Details

Number of Children *

Language Spoken at Home *

First Student

Student Full Name (English) *

Student Full Name (Arabic) *

School Year *

Date of Birth *

Sex *

Male
Female

Any Medical Concerns /symptoms/treatment

GP Name

GP Number

Second Student

Student Full Name (English)

Student Full Name (Arabic)

School Year

Date of Birth

Sex

Male
Female

Any Medical Concerns /symptoms/treatment (copy)

GP Name

GP Number

Third Student

Student Full Name (English)

Student Full Name (Arabic)

School Year

Date of Birth

Sex

Male
Female

Any Medical Concerns /symptoms/treatment

GP Name

GP Number

Fourth student

Student Full Name (English) ]

Student Full Name (Arabic)

School Year

Date of Birth

Sex (copy)

Male
Female

Any Medical Concerns /symptoms/treatment

GP Name

GP Number

Consent/ Use of Data

Permission to use photos *

Yes
No

Permission to be contacted by phone *

Yes
No

Permission to be contacted by email *

Yes
No

مدرسة عربية مستقلة، مقرها مدينة داربي، وهي المدرسة الأولى والوحيدة في المدينة، يقوم عليها أخصائيون عرب، يتمتعون بخلفية أكاديمية وتعليمية وإدارية

للتواصل

07934521847

info@arabiyaschoolderby.org

www.arabiyaschoolderby.org