The Atelier Guwahati // Registration Form
Email address *
Child's Name *
Your answer
Session for which enrolment is sought *
Required
Age Group *
Required
Date of Birth *
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DD
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Place of Birth *
Your answer
Blood Group *
Your answer
Gender *
Nationality *
Your answer
Language(s) spoken in the home environment *
Your answer
Tell us something about your child and her/his inclinations, interests and personality traits. *
Your answer
Health Information
Please ensure that all necessary health information is produced and is complete and accurate
Allergies *
Your answer
Any food to be avoided due to allergic reaction or dietary restrictions *
Your answer
Recent Illnesses/ Accident *
Your answer
Other(s) (Details of any developmental delay/ congenital anomaly) *
Your answer
Is your child attending (or has attended) any speech or occupational therapy? Please mention period of therapy and names of therapists. *
Your answer
Has your child attended any preschool/early years programs prior to this? *
Required
Name of Institution
Your answer
Location
Your answer
From
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DD
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YYYY
To
MM
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DD
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YYYY
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