Enrolment Form

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Saturdays 1-5pm at Fortismere School, North Wing

Creighton Ave, Muswell Hill, London N10 1NS

020 8361 9251

office@rustamschool.co.uk

Enrolment form for entry to class *

Surname: *

First name: *

Date of Birth *

Father’s name *

Mother’s name *

Address *

Mother's Contact Number *

Father's Contact Number *

Emergency Contact Number *

Mother's Email Address

Father's Email Address

Name of the previous Persian School (if Any):

Current Level of Persian: *

Name and address of current English school:

Year Group *

Telephone

Email:

How did you hear about Rustam School?

Notice: It is important for us to know of any special educational/medical needs your child might have so that we can ensure they receive the support they need and are kept safe whilst with us. Please be assured that all information will be kept confidential and for those that need to know in order to support your child:

Allergy :

Asthma

Special Educational Need (Eg Autism/ADHD)

Does your child have EHCP? `if so please provide details

Other

Instructions to the school for appropriate response and prevention:

Please Explain in details if any of above options are checked

I understand, accept, and agree to the following terms and Conditions *

I consent

1. Please inform your child’s English school about the pupil’s attendance at Rustam.
2. Our active Friends of Rustam/PTA group would appreciate any help with delivering cultural events. Please ask at the buffet.
3. For information about our policy and practice please ask at reception or refer to our website.
4. The £20.00 deposit is refundable once the required 1 month notice of withdrawal has been received and when there are no outstanding payments.
5. Fee must be paid at the beginning of the year or each term before entry to class.
6. We occasionally take footage of educational and cultural events, which may be posted on Rustam’s social media platforms. Please let us know if give your consent for your child to be included

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