Samskrita BhArati Samskritakendram bAlavargaH Registration 2019-2020
When : Saturdays 9am to 10:45am . Potential Start Date Saturday September 7th 2019

Where : Horner Jr. High School (map: 41365 Chapel Way, Fremont, CA 94538)

Fees : (Fee include Study material and tuition for children.)

$350/ year for first child   .  $250/year for each additional sibling. 

Website : http://www.fremontbalakendram.org . Questions : fremont@samskritabharatiusa.org

Email address *
Student Information
Child1 FULL NAME *
Your answer
Child1 Birthdate ( 5 Years as of 09/01/2019 ) *
MM
/
DD
/
YYYY
Child1 Grade in Fall 2019-20 ( Has to be enrolled in a school in that academic year or registered for home school ) *
Child 1 2019-2020 School Name - Verification may be requested. *
Your answer
Child1 Current Section in Balakendram: *
Child1 Food Allergies : *
Child2 FULL NAME:
Your answer
Child2 Birth Date ( 5 years old as of 09/01/2019)
MM
/
DD
/
YYYY
Child2 Grade in Fall 2019-20 - Has to be enrolled in a school in that academic year or registered for home school.
Child2 2019 School - Verification may be requested.
Your answer
Child2 Current Section in Balakendram:
Child 2 Food Allergies :
Parent Information
Mother's Full Name: *
Your answer
Father's Full Name *
Your answer
Address *
Your answer
City *
Your answer
Zipcode *
Your answer
Contact Information
Primary Phone (Mobile) *
Your answer
Second Phone (Mobile) *
Your answer
Secondary Email ( Primary email entered above ) *
Your answer
Emergency Contact: ( Someone Other than Mother/Father . <Name-Phone> ) *
Your answer
Parents Attendance ( At least one parent ) *
Please add the following to the Samskrita Bharati mailing list *
Required
How did you hear about us? *
Required
POLICIES:
Note : Both Primary and Secondary Email Addresses will be added to the Fremont Balakendram mailing lists for 2019-2020.
Required
PAYMENT:
First child - $350 . Each additional sibling $250.

ATTENTION : Look for PAYPAL Payment links on the confirmation page when you submit the form

Admission can be confirmed only if Payment is Received.

A copy of your responses will be emailed to the address you provided.
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