Online Application Form

 

 

Thank you for your interest in studying at Madina Institute. In order to take the next step, we need some information from you so that we can process your application.

 

Before proceeding please ensure that you have:

 

At least 15 minutes to complete the form in one session

 

Certified Copy of ID Document, valid passport (if foreign Student)

 

Certified Proof of residential address that is less than 3 months old

 

Most recent school Report (if in Matric – Grade 11 report otherwise your most recent School finishing report)

 

If the applicant is under 18, the following will be required from the Parent/Spouse/Guardian

 

Certified Copy of ID Document, valid passport (if foreign Student) of the person responsible for payment

 

Should you have any queries please email us at  applications@madinainstitute.ac.za or call +27 21 421 9027.

 

Should you prefer to fill in our offline form, download it MI Application Form v7

 

The admission rules can be found here Admission Rules

 

 

Banking details:

Account Name : Madina Institute NPC

Bank: ABSA

Account Type: Current Account

Account Number: 40 9257 0277

Branch Code: 63 20 05

 

 

Apply Online

Form 1A - Application Personal Details

*Title

Mr. Mr Miss Mrs Dr Other

*First Name

*Surname

*Date of Birth

Maiden Surname

*Gender

Male. Male Female

*Home Language

*Are you a South African Citizen?

Yes     No    

*Are you a South African Permanent Resident?

Yes     No    

South Africa ID Number

If you are not a Citizen or Permanent Resident please complete below

Country of Residence

Passport Number

Form 1B - Applicant Contact Details

*Home Address

Postal Code

Postal Address (if different to home address)

Telephone Number (include country and area code)

*Mobile Number

*Email Address

Form 1C - Parent/Spouse/Guardian Details

*Name

*Relationship

*ID / Passport Number

Postal Address (if different to Street Address)

Please Note: This information will be used as a reference for Next of Kin

Form 2 - Study Programme Applying For

*In which year do you want to commence your studies

2019 2020 2021 2022

*Please select the Study Programme (3 Year or 1 Year)

Note: an applicant who wishes to apply to study the 2nd or 3rd year must please submit all qualifications from your previous Institute of learning  You may be required to submit subject records where applicable/requested

*Academic Year

1st     2nd     3rd    

Note : Students may have to be interview by Madina Institute lecturers prior to acceptance

Madina Institute NPC is provisionally registered with the Department of Higher Education and Training until 31 December 2021 as a private higher education institution under the Act Registration certificate No 2018/HE08/00

Form 3A - Current Matric Student School Details

School Name

Exam Number

School Code - Completed by Admin

School Address

School Subject and Latest Result

Form 3B - Post Matric or Foreign Student School Details

School Name and Address

Exam Year

School Subject and Results

Foreign Students Only

Student Number

Year of Study

School Leaving Qualification

Returning Students (Alumni)

Year of Study at Madina Institute

Student Num

Prior tertiary qualification: (please list all institutes registered at – if applicable)

Please list the following

Highest Qualification Achieved

Year, Institute, Qualification Studied, Completed(Y/N)

Form 4A - Person Responsible for Paying the Fees (Mandatory)

*Fee Payer Title

Mr. Mr Miss Mrs Dr Other

*Fee Payer Surname

*Fee Payer Name

*Relationship of Fee Payer

*Fee Payer ID / Passport Number

*Fee Payer Home Address

*Fee Payer Postal Code

Fee Payer Telephone Number

*Fee Payer Mobile Number

*Fee Payer Email Address

Compulsory Payments

Application Fee

R250 (Two Hundred and Fifty Rands) payable with application

Registration Fee

R1000 (One Thousand Rands) payable at Registration

Fees Payment Agreement

A Discount of 10% when paying the full course fees will be granted if settled before 31 March of year of study

*Payment Plan: I would like my payment for the course to be split as follows: (max 10 Months)

1. 1 2 3 4 5 6 7 8 9 10 (Months)

Bursary Application Process

Form 4B - Supporting Financial Details

Please only fill out this section if you require financial aid

List Sources of Income - 1

List Sources of Income - 2

List Sources of Income - 3

Total Household Income

Total Household Expenses

Total Monthly Expenses is broken down into the following categories (Rand Value)

Food

Rental

Hire Purchase

Electricity, Water & Rates

Clothing

Court Orders

Subscriptions (DSTV, etc)

School Fees

Telephone / Cell Phone

Other -

Contribution Towards Study Fees - In case full bursary is not approved)

I can afford to pay the following amount towards the fees

A Discount of 5% when paying the portion of the course fees will be granted if settled before 31 March

I would like my payment to be split as follows (max 10 months)

1. 1 2 3 4 5 6 7 8 9 10 (Months)

Form S1 - Proficiency Requirements

Islamic Studies

Institution Name

Course(s) Completed

Date Completed

Ajaza Completed

Arabic Reading Proficiency

Rate your level of proficiency

*Quraan Recitation

None. None Beginner Intermediate Advance Superior select one

*Arabic Text

None. None Beginner Intermediate Advance Superior select one

Form S2 - Testimonials

Extracurricular Activity and Community Service

*List any Extracurricular activities that you have been involved in:

*List any Community Service activities that you have been involved in:

Please attach any relevant documentation to your application

*Certified Copy of ID Document, valid passport (if foreign Student

*Certified Proof of residential address Less than 3 months old

*Most recent school Report (if in Matric – Grade 11 report otherwise your most recent School finishing report)

*Motivation Letter for Applying (1 Page)

This is to certify that shall I be accepted into the Madina Institute programmes, the fees and additional conditions as described in the admission rules will be adhered to

*I accept

Yes     No    

We thank you for your application and wish you all the success Please submit the application and we will get back to you shortly

Fields with (*) are compulsory.