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About Houghton Muslim Academy
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About Us
Application Information (Estimated time: 10 Minutes)
Application for admission in
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2020
2021
2022
2023
2024
Applying for Grade
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
A. Student Information
Student Name:
Family/Last Name
First Name
Middle Name
Gender
Male
Female
Date of Birth:
Birthplace
Home Language(s)
Previous School(s)
Highest Grade Passed
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Sibling(s) Applying to HMA - Name and Grade
Sibling(s) Enrolled in HMA - Name and Grade
Learner Dexterity
Right Handed
Left Handed
Ambidextrous
B. Family Information
Parent/Guardian 1
First Name
Last Name
Nationality
Email Address
Cellphone
Home Tel
Physical Address
Employer
Profession
Work Telephone
Work Address
Parent/Guardian 2
First Name
Last Name
Nationality
Email Address
Cellphone
Home Tel
Physical Address
Employer
Profession
Work Telephone
Work Address
C. Educational History:
Has your child ever been enrolled at HMA?
Yes
No
Has your child skipped or repeated a grade?
Yes
No
Has your child been suspended or expelled from school in the past two years?
Yes
No
Any concerns of which to make us aware that would help us? (Transition, adjustments, academic)
D. Billing Information:
Financial responsibility of my child will be assumed by:
Relationship
Phone Number
Email
E. Emergency Contact Information (Other than parent)
In the event of an emergency contact
Work Telephone
Mobile Phone
Home Phone
Alternate Phone
Email
F. Documents
Medical form
Birth certificate
Parents I.D copies
Indemnity form
Previous school records
Proof of address
Proof of payment of R450
Send Application
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