Nitaq Supportive Education – Student Enrolment Form

Please complete this form to register interest or enrol in a course at NITAQ Academy. Our admissions team will review the details and contact you to confirm the final schedule, fees, and payment steps.

Student Details

Student Name *

Grade / Year *

School

Date of Birth

Student Email

Emirates ID Number

Upload Emirates ID (Photo/PDF) *

Learning Notes / Special Requirements

Parent / Guardian Details

Parent / Guardian Name *

Relationship *

Mobile Number *

Alternate Number

Parent Email *

Course / Program Details

Course / Subject Interested In *

Student Goal

Preferred Mode

Online In-person Either

Preferred Timing

Morning Afternoon Evening Weekend

Preferred Start Date

Emergency Contact

Contact Name

Relationship

Mobile Number

Additional Notes

Terms & Conditions

Refund Policy

Declaration

I confirm that the information provided is accurate. I understand that enrolment, schedule, fees, and payment terms are subject to confirmation by NITAQ Academy. I agree to follow the academy’s rules, attendance expectations, terms and conditions, and refund policy.

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Signature of Parent / Guardian

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Signature of Student

Date