Antigua and Barbuda
Bosnia and Herzegovina
British Virgin Islands
Central African Republic
Democratic People's Republic of Korea
Democratic Republic of the Congo
Northern Mariana Islands
Papua New Guinea
Republic of the Congo
Sào Tomé And Príncipe
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Trinidad and Tobago
US Virgin Islands
United Arab Emirates
Madinah Boys (18-24 years)
Madinah Girls (18-24 years)
Bab Boys (14-17 years)
Bab Girls (14-17 years)
Birth Date (DD/MM/YYYY)
Full Name According to the Passport
Father's Full Name
Whatsapp Number Of Parent (+44)
Name of Your Jamaat/Islamic Centre
Country and City of Residence
What is your ethnic background (e.g. Khoja, Pakistani, Irani etc.)
Nationality (as per passport)
Issuance date of Passport - (DD/MM/YYYY)
Please tell us about any disabilities, illnesses, or medical needs that you have
Please tell us about any dietary requirements/allergies that you have
Please tell us about any learning difficulties or behavioural disorders such as ADD/ADHD that you have
Have you ever attended any Islamic Short Courses as a student? If yes, please provide details
Please let us know if you have previously applied for either the Madinah and/or Bab courses and the result of your application
Have you ever attended any Islamic Short Courses as a mentor/helper? If Yes, please provide details
Other than the answers above, have you been to Iran before? If so, when and for what purpose?
Why do you want to attend the course and how will you use this experience if you are selected?
Please mention any specific areas of interest or topics you would like to learn about in this course
Please tell us in detail about your educational history in Islamic studies. (inc: dates, names, institutions, subjects studied & results)
Please tell us about your secular studies and field of studies (i.e. area of specialization)
Please add here any further information that you feel will support your application
Next of Kin 1 (inc: Name, Relationship,Mobile & Email)
Next of Kin 2 (inc: Name, Relationship,Mobile & Email)
Referee 1 (inc: Name, Jamaat, Mobile & Email)
Referee 2 (inc: Name, Jamaat, Mobile & Email)
* I understand that Huquq funds will be used to subsidise my cost. I confirm that I cannot afford to pay the full cost.
How did you hear about the course
The WF Newswire
From My Regional Federation
Announcement/Poster in Islamic an centre
From a friend/family member
* Please submit your passport copy and passport photo to email@example.com
* Price of the course is subject to change if airfare or visa costs go up. Costs are based on the participant flying from/to LHR (UK).
* I hereby consent to The World Federation/CoEJ using photographs and/or video recordings of me during my time on the course which includes, but is not exclusive to, my journey to and from the airport and my time in the classes and activities that form part of the course. I understand that the images and recordings may be used in print and digital media formats, including print publications, websites, e-marketing, posters, banners, advertising, film, and social media. I understand that images on websites can be viewed throughout the world and not just in the United Kingdom and that some overseas countries may not provide the same level of protection to the rights of individuals as the EU/UK legislation provides.
I do consent to receiving further information on services. The information on this form will be retained by CoEJ for its use and may be shared amongst member Jamaats and regional bodies as and when necessary and requested. We may also use the information to inform you of events/projects that we or our affiliates feel may be of interest to you. I confirm that to the best of my knowledge the information submitted is accurate.
* Successful candidates who retract from the course then your deposit will be nonrefundable. Unsuccessful candidates will be refunded in full. Travel/health insurance is mandatory for the trip.