Admission Form

We appreciate your interest for admission in Darul-Uloom Al-Madania. We strongly encourage you to take your time to fill out the application. Be sure to have all the required dates and paperwork ready before you begin the application process to avoid any delays.

Before you fill out the application:

Please review the following before filling out the online application. Please note that we do not accept international students.

Click to preview the required fields in the admission application.
A scanned copy of your most recent religious and secular education report cards.
A scanned copy of your immunization record.

If all the required information is available, please proceed to our admission application.

After the submission of application:

In order for us to process your application, all the requested information and above mentioned documents are required. The following will take place once we receive your application along with the requested documents:

The application will be placed in our applications’ queue and will be processed in the order it was received.
Process time varies depending on the number of applications in the queue.
Applicants’ in person interview is part of our application process.
Placement test will be given to all interviewees based on the grade level mentioned in their application at the time of interview.
Since we are a boarding school, we have limited space available for new admissions. After the completion of application process and admission approval, the application will be placed on our waiting list. We will contact you once we have space available for the student in our boarding school.

Student Information

First Name*

Middle Name

Last Name*

Date of Birth*

Gender* Male Female

Languages you speak and /or read*

Citizenship*

Status in US*

Social Security (Last 4 digits)*

Place of Birth*

School Applying For*

Course Applying For* Hifz Alim

Present Religious Education:

Name of Institute*

Contact Number

Name of Contact Person

Date Attended From

Attended Until

Nazira Repititions

Quran Memorization

Reason of Departure

Present Secular Education:

Same as Religious Education

Name of Institute*

Contact Number*

Name of Contact Person*

Date Attended From*

Attended Until*

Grade Completed*

Parent / Guardian Information

First Name*

Middle Name

Last Name*

Applicant Relationship*

Other*

Address*

City*

State*

ZIP Code

Country

Home Phone*

Work Phone

Cell Phone*

Email*

Place of Birth*

Citizenship*

Occupation

Primary Emergency Contact

Full Name*

Home Phone*

Work Phone

Applicant Relationship*

Other*

Secondary Emergency Contact

Full Name

Home Phone

Work Phone

Applicant Relationship

Other*

In order for us to begin processing your admission application, we need a recent report card and updated immunization record of the applicant. If the scanned copies of the documents are available, you can upload them now. The supported formats are pdf, jpg, jpeg and png. Individual file size should not exceed 1mb. You can also zip the files and upload them as well.

Upload Report Card and Immunization Record
* You can select multiple files. to upload
* Please make sure your file name DOES NOT include underscore "_" .

Please answer the security question

Jazakallahu khair for submitting admission application with Darul Uloom Al Madania. We will review the provided information and will contact you soon with the application process status.

If you have any further questions or concerns, you can email us at admissions@madania.org.

Jazakallahu khair

Admissions Department,

Darul Uloom Al Madania

182 Sobieski Street, Buffalo, NY 14212