Dharma School Student Registration Form
2021-2022 Gardena Buddhist Church Registration Form (One student per form)
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Student's Name: *
Birth Month & Year (MM/YYYY) *
Grade: *
Address *
Student's Email (required for 9th - 12th grades)
Emergency Contact Name *
Emergency Cell Phone Number (no dashes) *
Mother/Guardian Name: *
Mother/Guardian Cell Phone Number (no dashes) *
Mother/Guardian Email: *
Father/Guardian Name: *
Father/Guardian Cell Phone Number (no dashes) *
Father/Guardian Email *
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