Adni Islamic School

1. Registration No :

2. Level* : —Please choose an option—HadonahRaudhahPrimarySecondaryPre-University(Please select level to enroll: Hadonah/Raudhah/Primary/Secondary/Pre-University)

3. Class : —Please choose an option—Primary 1Primary 2Primary 3Primary 4Primary 5Primary 6(For primary, please specify class to enroll : Primary 1/2/3/4/5/6. e.g. Primary 2)

4. Class : —Please choose an option—Secondary 1Secondary 2Secondary 3Secondary 4Secondary 5(For secondary, please specify class to enroll : Secondary 1/2/3/4/5. e.g. Secondary 4)

5. Semester : Semester 1Semester 2(Select semester to enroll: Semester 1/2 e.g. Semester 1)

6. Admission : 20242025(Select year to enroll e.g 2024)

7. Full Name* :

8. Birth Certificate :

9. I.C No :

10. Passport :

11. Date of Birth :

12. Age :

13. Place of Birth :

14. Gender : MaleFemale

15. Nationality :

16. Race :

17. Disability / Learning Disability : NoYes

18. Tel. No :

19. Email :

20. Correspondence Address :

21. Permanent Address :

22. Previous School Attended :

    No.	School	School Address	Year	Grade
    1
    2
    3

23. Spoken Language : EnglishBahasa MalaysiaMandarin

Child No of Siblings

Does your child have any allergies or any medical condition? Please state:

1. Medicine : NoYes

2. Immunisation : NoYes

3. Food : NoYes

4. Others : NoYes

1. Name :

2. Passport No :

3. I.C :

4. Nationality :

5. Date of Birth:

6. Highest Education :

7. Occupation :

8. Income : RM

9. Employer :

10. Nature of Business :

11. Office Address :

12. Tel. No :

13. Fax :

14. Mobile Number :

15. Email :

1. Name :

2. Passport No :

3. I.C :

4. Nationality :

5. Date of Birth :

6. Highest Education :

7. Occupation :

8. Income : RM

9. Employer :

10. Nature of Business :

11. Office Address :

12. Tel. No :

13. Fax :

14. Mobile Number :

15. Email :

1. Name :

2. Passport No :

3. I.C :

4. Nationality :

5. Relation :

6. Occupation :

7. Employer :

8. Correspondence Address :

9. Permanent Address :

10. Telephone Number :

Social MediaFriends of FamilySchool WebsiteSchool WhatsAppOther

I understand and agree to following:

1.   2 (two) months notice must be served before withdrawal from school.

2.   Any outstanding balance will be deducted from deposit in the event of withdrawal from school.

Name :

Date :

Signature : ______________________

Please Submit with this form following :

1. 1 passport sized photograph (Malaysian Student)

2. 1 passport sized photograph (Foreign Student)

3. Copy of Birth Certificate and translation ( if not in Malay or English)

4. Copy of Identity Card or Passport of the Student

5. Copy of Identity Card or Passport of the Parent

6. Copy of Marriage Certificate (Foreign Parents only; for visa purposes)

7. Copy of Previous School Leaving Certificate

8. Other relevant document

Your file/document must be uploaded together with this form