Ankur Vidyalayam Registration (2016-17)
Parents Information
Father's Name
Mother's Name
Email *
Primary Phone *
Alternate Phone
Child Information
Name *
Date of Birth *
Grade *
Does your child have any medical problem? *
If YES, Please indicate the problem and action, if any, required by teachers during class
Ankur Vidyalayam Suggested Donation
For first child $120/year.
For second child onwards $90/year
Acknowledge *
Required
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This form was created inside of Kriya Yoga Institute Inc..