Student Registration — Alifya Education

Parent / respondent email

First name

Second name

Start date of classes

Class

Year of student

Gender

Date of birth

Nationality

Main study programme

Study sub-programme

Hours per week

Study campus

Subjects registered

Math English Science Biology Chemistry Physics Other

Student address (postcode only)

Complete house / flat address

Emergency contact no. 1

Emergency contact no. 2

Full name of first guardian

First guardian contact no

Full name of second guardian

Second guardian contact no

Permission for Alifya Education members to watch the child on activities inside the premises while learning

Yes No

Permission for Alifya Education to use the photo and any educational interview of the child on social or print media

Yes No

I confirm the information is correct and I agree to the terms and conditions of the Alifya Education Parents Agreement

I confirm I don't confirm