Gurmat School Registration Form for 2010-2011

Registration Date:_____________________ AGE:________

STUDENT INFORMATION OTHER INFORMATION

LAST NAME:___________________________ FATHER’S NAME:

_____________________________________
FIRST NAME:__________________________

MOTHER’S NAME:
MIDDLE NAME:_________________________
_____________________________________
DATE OF BIRTH________________________
(day / month / year)
PARENTS CELL # (1) :
_____________________________________
MALE  FEMALE 

PARENTS CELL # (2) :

STUDENT CELL #:

____________________________________ HOME TEL # :__________________________

**STUDENT EMAIL:
ADDRESS:______________________________
__________________________________________
_______________________________________
For Group C only (13yrs+)
_______________________________________

Would you like to volunteer/assist in classes? If yes,

please indicate which class: **PARENT EMAIL:

Discussion  _____________________________________
Paath 
**please print clearly, very important since most
Punjabi  communication including important dates and
events will be via email

Does your child have any dietary restrictions or health concerns? i.e allergies

____________________________________________________________________________________

____________________________________________________________________________________

I agree to bring my child on a timely fashion to Gurmat School. I will also ensure that my child brings all
of his/her required materials for school and review all learned at the Gurmat School throughout the week.
I understand that the consequences of not doing this may result in the expulsion from Gurmat School. I
also understand that three consecutive absences will results in an expulsion from Gurmat School unless
previously arranged with a senior staff member.
________________________________
Parent signature