t Register Student for Tuitions – 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

Student Full Name *

School Year *

Date of Birth *

Sex *

Male
Female

Any Medical Concerns /symptoms/treatment

GP Name

GP Number

Tuition Preferences:

Please select your preferred tuition options *

Face-to-Face Group Lessons at Landau forte college (Arabiya School Derby)
Online Group Lessons
Online One-to-One Lessons

Specify Other Subjects

Subjects of Interest (Select all that apply):

Subjects of Interest (Select all that apply): *

English Language
English Literature
Mathematics
Combined Sciences (Biology, Chemistry, Physics)
History
Geography
Other (Please specify):

Academic Level

Academic Level (Select one): *

Key Stage 2
Key Stage 3
GCSEs
A-Level

Consent/ Use of Data

Permission to use photos *

Yes
No

Permission to use photos (copy) *

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