Student Application Student Application Child's Details Child's First Name * First name (and any middle names) Child's Surname * Last Name Gender * Male Female Date of Birth * Preferred Branch * Edmonton Enfield Harlow North Finchley Slough Are there any other Safar Branches you want to be considered for Edmonton Enfield Finchley Harlow Slough No other branches Does your child have any Health Conditions or educational needs? * Yes No Details of Health Conditions * Asthma Allergy Bladder Issues Learning Difficulties Physical Disability ADHD/Autism Visual Impairments OtherOther Provide Details of health conditions or learning difficulties Do you provide permission for Safar Academy to take Photos & Videos of your child for promotional purposes ? Yes No Photos will be used for purposes such as on the Safar website, promotional videos etc. Photos will never be shared with 3rd parties Family Details Do you have any children currently studying at Safar Academy? * Yes No Name of Child Currently Studying at Safar Academy Family Reference number Family Reference Number for current Child at Safar e.g SP073 Father's Name * Mother's Name * Landline/Home Number Primary Mobile Number * This is the Mobile number we will send messages to when your child is at the Academy Secondary/Additional Mobile Number Primary Email Address * Secondary/additional Email Address Address * Address Address Address Town Town City City Postal Code Postal Code Emergency Contact Details These details should be different to the fathers/mothers. These will only be used in the case of an emergency when the parents cannot be reached. Full Name * Phone Number * Relationship (e.g Aunt, Grandmother, Family Friend) * Any Other Comments/Notes regarding application If you are human, leave this field blank.