Admission Form

Parents Details
Father’s Full Name*
Father’s Telephone*
Mother’s Full Name*
Mother’s Telephone*
Section B – Education and Qualifications
Please give your full education history with the qualifications awarded. Where results have not been awarded please write predicated results.
School Education*
School attended (give full name and town) Qualification & Subjects (e.g. GCSE, A-Level, BA etc.) Grade/ Expected Grade Year
Work History
From MM/YYYY To MM/YYYY Organisation Job/Role Paid/Volunteer

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Section C - Personal Statement
Please write your personal statement here, continue additional sheet if necessary:
Please write the reasons why you are applying to MCM and information about your personal interests and hobbies.*
Section D - Further Information
Do you have any disability, health condition or dietary requirement that we should be aware of?*
- Yes
- No
If yes, please give details
Are you or have you been a member, follower or supporter of any organisation or group, whether religious, political or otherwise?
- Yes
- No
If yes, please give details
Please indicate if you speak any other languages aside English, and the level (written, spoken):

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Section E – Referees’ Declaration
Please provide details of two referees whom we can contact on successful application. Referees should include a previous academic tutor/teacher and if available a reference by your previous Islamic Studies tutor. If not available, then you may provide the details of a person of good standing or a previous employer. Referees should note that we may use the information on this page to contact the Referee to verify the information provided.
First Referee
Name (BLOCK CAPITALS)*
Organisation*
Position*
Address*
Address City State / Province / Region ZIP / Postal Code
Phone
Email address*
Any relation to applicant*
Second Referee
Name (BLOCK CAPITALS)
Organisation
Position
Address
Address City State / Province / Region ZIP / Postal Code
Phone
Email address
Any relation to applicant

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Section F – Method of Payment
Please double check the fee of your course from the relevant course pages.
How do you intend to pay the fees?*
Source of Funding? i.e. parents, savings, etc.*
Section G – The Applicant’s Declaration
This section must be signed by applicant.
By signing this form, you agree to be bound by the fee structure above and any regulations and rules set up by the college, which can change time to time.
- I apply to the Minhaj College Manchester.
- I confirm that I am a fit and proper person to be admitted to the College.
- I confirm that I do not have any criminal convictions, other than any arising under the Road Traffic Acts, and any I have detailed on the attached separate sheet, and that I am not aware of any incidents in which I have been involved that might lead to a criminal charge or conviction against me.
- I have not, either in the UK or elsewhere:
  - been censured, disciplined or publicly criticised by any professional body to which I belong or belonged;
  - or been dismissed from any office or employment;
  - or been excluded from a school/college/university course for misconduct;
  - or refused entry to any educational institute due to the above reasons.
- I am not aware of any circumstances that would make me unsuitable for this course.
- If my application is approved, I understand and agree:
  - to conform to the Bye-Laws, Rules and Regulations of MCM as now exists, or as may in future be altered,amended or enlarged, and I will, to the best of my ability, promote the objectives of MCM.
  - that I shall be subject to the Disciplinary Rules of MCM.
Name (BLOCK CAPITALS)*
Signature*
- Please tick to agree to the above and electronically sign
Minhaj College Manchester adheres to the rules and regulations of the Data Protection Act 1998. We will use the information provided on this form to process your application. Please ensure that the details on the form are completed accurately. You should note that providing incorrect information, or failure to advise the Admissions Team of a change to information, could result in the instigation of disciplinary proceedings.

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Admission Form - 2019-20

Step 1 of 5

Current Residential Address

Parents Details

Section B – Education and Qualifications

Section C - Personal Statement

Section D - Further Information

Section E – Referees’ Declaration

First Referee

Second Referee

Section F – Method of Payment

Section G – The Applicant’s Declaration

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School attended (give full name and town)	Qualification & Subjects (e.g. GCSE, A-Level, BA etc.)	Grade/ Expected Grade	Year

From MM/YYYY	To MM/YYYY	Organisation	Job/Role	Paid/Volunteer