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Selection of Institute
Basic Info
Student Name (Full Name):
*
As mentioned in Date of Birth Certificate or SSLC.
Age:
*
Date of birth:
*
Nationality:
*
Indian
The admission is restricted to indian nationals.
Gender:
*
Male
Female
Religion:
*
The courses provided in this Institution is related to deep study of islamic theology and science. We are providing courses for material education and islamic education for new muslims in other institute and web platforms. Please refer our academic website.
Residential Status:
*
Kerala Resident
Non Resident Indian
Non Resident Keralite
Other Kerala Indian Resident
Email address:
*
Mobile Number for SMS Notifications :
*
It must be a India Registered number, and do not enter +91.
General Categorisation:
*
General
Orphan
Physically Disabled
Other
Specify Other General Category:
Date of Father's death:
Specify the Disability:
WhatsApp Number:
*
Facebook / Instagram ID:
Adhaar Number:
*
Passport Number:
Marital Status:
*
Yes
No
If Yes, Marriage Date:
Name of Father:
*
Education of Father:
*
Profession/Occupation of Father:
*
Name of Mother:
*
Education of Mother:
*
Profession/Occupation of Mother:
*
Number of Brothers:
*
Number of Sisters:
*
Your Position in Children:
*
Family Income:
*
Contact Details
Permanent Address
House Name/ Flat No.:
*
Place:
*
Post Office:
*
PIN Code:
*
State:
*
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
National Capital Territory of Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
District:
*
Alappuzha
Ernakulam
Idukki
Kannur
Kasaragod
Kollam
Kottayam
Kozhikode
Malappuram
Palakkad
Pathanamthitta
Thiruvananthapuram
Thrissur
Wayanad
City / Nearest City:
*
Residence Phone with STD Code:
*
It can be Mobile Number also. Mention your ISD Code if you are not entering an Indian Number.
Father’s Mobile:
*
Mention your ISD Code if you are not entering an Indian Number.
Mother’s Mobile :
Mention your ISD Code if you are not entering an Indian Number.
Any other Guardian Number:
Mention your ISD Code if you are not entering an Indian Number.
Communication Address
Permanent address and communication address are same:
House Name/ Flat No.:
*
Place:
*
Post Office:
*
PIN Code:
*
Your Education
Your Education
Name of School attended last year:
*
Place of School:
*
Medium of Instruction in your previous school:
*
English
Malayalam
Urdu
Tamil
Kannada
Arabic
Other
Class attended last year:
*
4th Std
5th Std
6th Std
7th Std
8th Std
9th Std
10th Std
Plus One
Plus Two
Year of leaving school:
*
Name of Madrassa attended in previous years:
*
Please mention place of Hifz College also
Last class attended in Madrassa:
*
4th Std
5th Std
6th Std
7th Std
8th Std
9th Std
10th Std
Plus One
Plus Two
Year of Completing of Qur’an Hifz:
*
SSLC No:
Mukhthasar Education
Name of institution last studied (Mukhthasar)
*
Course duration (years)
*
Leaving month & year
*
Course syllabus
*
Jamiathul Hind
Ma'din
Other
Kithabs Studied
كتاب الصرف والنحو
عمدة
خلاصة الفقه الإسلامي
تعليم المتعلم
هداية الأذكياء
رياض الصالحين
جوهرة التوحيد
تصريح المنطق
تحفة الإخوان
خلاصة الألفية
فتح المعين
شرح السنوسي
مرقات
نفائس الارتضية
كنز الراغبين للمحلي
جمع الجوامع
مختصر المعاني
القطبي مع المير
تفسير الجلالين
مشكاة المصابيح
نخبة الفكر
الرشيدية
شرح العقائد
خلاصة الحساب
ميبدي
ملا حسن
تشريح الأفلاك
صحيح البخاري
تفسير البيضاوي
If any other than above, specify here:
Academic Qualifications
SSLC
Board/University
*
Year of Passing
*
% of Marks
*
Plus Two / Diploma
Stream/Subject
*
Board/University
*
Year of Passing
*
% of Marks
*
UG Passed/Ongoing
Stream/Subject
*
University
*
Year of Passing/Last Exam Date
*
% of Marks
*
PG Passed/Ongoing
Stream/Subject
University
Year of Passing/Last Exam Date
% of Marks
Other Qualifications and Abilities You Have :
Achievements and Awards :
Leaderships You Serve :
Your Language Proficiency :
Arabic
*
Excellent
Good
Average
Below Average
English
*
Excellent
Good
Average
Below Average
Urdu
*
Excellent
Good
Average
Below Average
Malayalam
*
Excellent
Good
Average
Below Average
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