Shree Jalaram Mandir Bal Vihar Class - Registration Form
- Age group 5 to 15
- Learn about Hindu Shlokas, Prarthana, Hindu Culture, History and our Festivals
- Date : September 08th, 2018 to December 15th, 2018
- Every Saturday from 1 PM to 2 PM
- Register Online or at Mandir Office


Any questions feel free to ask:

Ashish : +1 630-313-0024
Jigar : +1 414-739-3505

Child’s First Name *
Your answer
Child’s Last Name *
Your answer
Date of Birth *
MM
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DD
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YYYY
Age *
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent Phone Number (Cell) *
Eg: 7383950897 - Only 10 digits and without space and "+1"
Your answer
Parent Phone Number (Home) *
Eg: 7383950897 - Only 10 digits and without space and "+1"
Your answer
Parent Email Id *
Your answer
Do you want updates from SJM of our events/programs ? *
Are parents interested for volunteer work for Bal Vihar Class ? *
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