Online Admission Form

Instructions

-- Important instructions for admission ---

Please fill out the form carefully.
We offer admissions based on financial aid. If you are experiencing financial hardship, please select “Need Financial Aid” below. You will be required to upload your tax return documents for financial aid applications, so the administration can assess and potentially offer a tuition discount or waiver.
Madina Center does not have the capacity to service special Needs students.

Student Detail

First Name *

Last Name

Date Of Birth *

Gender *

Mobile Number

Email

Student Photo

Address

I consent to receive SMS messages from Madina Center regarding important school updates, including attendance, fees, and event notifications. I have also reviewed the Privacy Policy. *

YES

Parent Detail

Father Name

Father Phone

Father Email

Mother Name

Mother Phone

Mother Email

Primary Contact

If Primary Contact Is * Father Mother Other

Name *

Relation *

Email *

Phone *

Address *