JSGA Pathshala Registration

JSGA Pathshala Registration

Jain Society Of Greater Atlanta
Student must be at least 3 years old & Potty Trained by August 1st of the current year.

Suggested minimum donation for the JSGA Pathshala program is $35 per child.
Please submit one form per child.

Pathshala Registration Information
Parent Member Id: *
Note: We request all JSGA members to enter correct member Id, however for non-members please enter 9999 as a member Id.
Father's Full Name *

First Name Middle Name Last Name
Mothers Full Name:

First Name Middle Name Last Name
Father's Email: *
example@example.com
Mother's Email: *
example@example.com
Father's Phone/Cell: *
Please enter a valid phone number.
Mother's Phone/Cell: *
Please enter a valid phone number.
Parent's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How many children/s do you have? *

1 2 3
Children/s Information >

Child must be at least 3 years old and potty trained.
Child-1 Name *

First Name Middle Name Last Name
Child-1 School Grade
Child-1 Current Pathshala Level
Child-1 Gender

Male Female
Child-1 Allergies (If any)
Child-1 Additional Info (If any)
Child-2 Name *

First Name Middle Name Last Name
Child-2 School Grade
Child-2 Current Pathshala Level
Child-2 Gender

Male Female
Child-2 Allergies (If any)
Child-2 Additional Info (If any)
Child-3 Name *

First Name Middle Name Last Name
Child-3 School Grade
Child-3 Current Pathshala Level
Child-3 Gender

Male Female
Child-3 Allergies (If any)
Child-3 Additional Info (If any)
Terms & Conditions *

Your child's teacher may include classroom projects, activities student photos, writing, artwork, etc. on the home page or in marketing materials and might include students when they are involved in individual or large group & classroom projects.
I agree *

I give JSGA permission to publish student and families pictures in temple related social, printed, and online media.
Any additional information you would like to provide ?
Minimum suggested donation. You are welcome to enter/donate more to help Pathshala more!
Payment is OPTIONAL at this time. Please pay amount due below, if you wish to pay now.

Note: You should receive an email with total anyways & JSGA Treasurer will send seperate pledge (paid or outstanding) in coming weeks as well.

Thank you for your support to JSGA.
Do you wish to pay now? We accept all major credit cards and PayPal. Disclaimer: We do not store any financial information and use secured transaction method. *

Yes No
Total amount due:

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USD JSGA Pathshala registration 2020-2021

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JSGA Pathshala Registration

Children/s Information >