[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
[The specific questionnaire from the Ministry of Education for enrolment of Baha’i students]
Islamic Republic of Iran
Ministry of Education
Head Office of Education of Tehran
In the Name of God
The applicant is required to answer the questions below with complete honesty
- Name –------ Family name ----- Name of father --------
Birth certificate number------- Date of birth ------- declaration number ------
- Are your father and mother Baha’is?
- Are you a follower of the Baha’i sect?
- How many years have you been following this faith?
- Do you discuss your faith in class?
- Who among your relatives and acquaintances are followers of the Baha’i faith?
- Do you agree to withdraw from this faith?
- Any additional information that you think it is necessary to provide:
Place for signature -----