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Student Registration

TADIKA DUTA IMAN (RANTAU PANJANG) (1243307-W)
LOT 2918A & 2919A
JALAN LEBUH RAYA RANTAU PANJANG PASIR MAS
17200 RANTAU PANJANG
KELANTAN

0102394060

Program Info

Session *

Program

CEP

COMBO CEP

FULL DAYCARE

HALF DAYCARE

INTENSIVE CLASS LITTLE QARI (Registration Is Closed)

INTENSIVE CLASS SCB/FTER (Registration Is Closed)

KG1-4

KG1-5

KG2-5

KG2-6

PRA TAHFIZ

Student Info

Full Name *

Name Tag *

Primary Phone *

Local International

E-mail *

Address *

ID Type

NRIC

Birth Cer No. *

Gender *

Male Female

Date of Birth *

Place of Birth *

No. of Siblings *

Child No. *

Previous School

School Name

Referred From (About Us)

Health Info

Health *

Enter if there are allergies, illnesses and medication intake

Father/Guardian Info

Full Name *

ID Type

MyKad

Phone *

E-mail *

Occupation *

Employer *

Office Address

Office Phone

Salary *

Mother Info

Full Name *

ID Type

MyKad

Phone *

E-mail *

Occupation *

Employer *

Office Address

Office Phone

Salary *

Emergency Info

Full Name *

Phone *

Relationship *

Terms and Conditions

Full payment for 2024 Annual Registration Fee to be paid latest by 15 December 2024 or your booking seat will be open to other students.

I have read and understand Polisi Parents Handbook (https://drive.google.com/file/d/1IYncu3V18S9Hg8dNupIV06tJZKZsBW69/view?usp=sharing)
& agreed with AKURJANJI (https://forms.gle/ZyTQU74DsXjGi52K8)provided

I agree to the above terms and conditions

Username

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