HUDSON VALLEY SIKH CULTURAL SOCIETY
84 Genung Street,
Middletown NY Gurmat School Registration Year 2018
Date Of Birth:
Please Check One: Are you a ....?
Parent/Guardian name: Father Name/ Relationship to Child (if guardian)
Parent/Guardian name: Mother Name /Relationship to Child (if guardian)
Parent/Guardian: Complete address
Contact Details: Cell
Contact Details: Home Phone
Contact Details: Email
How would you like to be contacted?
Does your child understand Punjabi
Just a Little
Not at all
Language spoken at home
Punjabi & English
Emergency Contact: Name & Number
Is there any other Information that we should know about your child/student?
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