Al-Burhan Grammar School for Girls
Spring Road Centre, 258 Spring Road,
Tyseley, Birmingham, B11 3DW
Tel: 0121 440 5454
Registration Form
Pupil’s Details
Surname:
First Name:
Date of birth:
Age:
Address:
Post Code:
Home Tel:
Nationality:
Country of origin:
Parents Details
Father’s Name:
Occupation:
Mobile:
Email:
Mother’s Name:
Occupation:
Mobile:
Email:
Medical Details
Name of Doctor:
Post Code:
Telephone:
Important Medical Information: (e.g. Asthma, Diabetes, Allergy)
Details of Present School
Name of School:
Address:
Post Code:
Telephone:
Date attended: From
To:
Reason for leaving:
Please return the completed form along with the following documents:
•
•
•
A photograph and the latest school report.
A copy of your daughter’s birth certificate or the identification page of her passport.
Non–refundable Registration fee of £25.00.
Declaration
I undertake to abide by all the School regulations. I understand that giving false information may
affect the offer of a place.
Parent’s/Guardian’s signature:
Date:
For Office Use Only
Payment Details: Amount:
Date Received:
Exam Date:
Result: Pass
Accepted: Yes / No
Waiting List:
Date of Start:
Proof of Age:
Comments (if any):
Fail