Pathshala

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Please fill out this form to enroll your child in Pathshala

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Child 1

First Name

Last Name

Age

Grade as Of August 2021

Date of Birth

Student Type

Previous Class

Special Needs: (Allergies, diet restrictions, etc...)

Child 2

First Name

Last Name

Age

Grade as Of August 2021

Date of Birth

Student Type

Previous Class

Special Needs: (Allergies, diet restrictions, etc...)

Parent(s)/Gaurdian(s) Information

Fathers Full Name

Mothers Full Name

Home Address

Contact Information

Home Phone

Mom Cell Phone

Dad Cell Phone

Email 1

Email 2

Special Notes to Teacher(s)

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