REGISTRATION FORM

KASSIM DARWISH GRAMMAR SCHOOL FOR BOYS

Childs Details
Surname
First Name(s)
Address
Postcode
Telephone No

Date of Birth
Current school
Address
Telephone
What year is your son
currently in?

Postcode
Fax

Year 6

Year 7

Year 8

Year 9

YES
Is the child looked after by a Local Authority?
(Sometimes referred to as being in care)
If YES, which Local Authority?
Does the child have a special educational, medical or domestic
YES
need?
If so, please give details below and, if necessary, continue on a separate sheet.
You must also attach supporting evidence from a recognised professional.
Does the child have a Statement of Special Educational Need?

*Year 10
NO

NO

YES

NO

Yes

No

YES

NO

Parent/Guardian Details
Full Name of Parent/Guardian
(Mr/Mrs/Miss/Ms)
Address (if different from above)
Post Code
Work Tel No:

Home Tel No
Mobile Tel no
Email address
Relationship to child

Do you have legal responsibility for this child?

Does the child that this application relates to have a brother
already attending this school?

If YES, please provide the following information relating to the sibling:

Surname
First Name(s)
Address
Postcode
Date of Birth
Form
Please give details of any brothers and/or sisters who are currently attending Manchester
Muslim Preparatory School or the Manchester Islamic High School for Girls

Name

D.O.B
Birth

Form

School

Ethnic Background
Please study the list below and tick one box only to indicate the ethnic background of the
child requiring a place at secondary school.
Black - Caribbean heritage

White - British/European
Black - Other

Black - African heritage

Indian
Pakistani
Chinese

Bangladeshi
Arab

Any other minority ethnic group

(please specify)

Parents/Guardians Declaration

Your son/ward must be in Year 6 (or above where applicable)

The school does not allow entry into Year 11. *Year 10 pupils are only considered if applications
are received before the October half term.

Please enclose a fee of 25.00 for your form to be processed.

All parts of this form must be completed. Incomplete forms will be returned.

All cheques should be made payable to KDGB, with your sons name clearly printed on the
back.

Please enclose a copy of either your sons Birth Certificate or the Identification page
of his passport.

Please post your applications to: Admissions, KDGB, Hartley Hall, Alexandra Road South,
Chorlton-cum-Hardy, MANCHESTER, M16 8NH.
(0161) 860-7676 (0161) 860-0011
admin@kdgrammar.co.uk Visit: www.kdgrammar.co.uk

Sign
Date

(Parent/Guardian)