First Name*
Last Name*
Date of birth*
Current Year Group (Year last completed)* —Please choose an option—ReceptionYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13
Gender*MaleFemale
Nationality
Current School
Current School City*
Does your child have a SEND (special educational need or disability)?ADHDASCSEMH
Other (please state)
Do you have a sibling at Jaffaria Academy? YesNo
If you answered yes, what is your sibling’s name?
Your Email*
Phone No.*
Full Address*
PostCode*
City*
Council*
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How did you hear about us?*
Please check that all information is correct before submitting.
Once you submit this registration form, please make a payment of £100 per child to our bank account. Your registration will only be considered once the payment has been received.
Kindly add your child’s school year, first initial, and last name to the payment reference, i.e. if your child’s name is Sajjad Ali and in year 5, then write (S ALI 05).
Bank Details Jaffaria Academy Ltd. A/C: 1400 0485 Sort Code: 04-06-05
We agree with the declaration and fees requested above.*
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