Shree Ram Mandir Gujarati School
Enrollment Form 2023 - Cost of Enrollment £75 for the full year. Any queries please email school@lohanaleicester.org.uk
Full Name
*
First Name
Middle Name
Last Name
Student DOB
*
Please select a day
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Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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Year
Parent's E-mail
*
Home Landline No
Parent / Guardian Mobile No
*
Used as Emergency Contact
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal Code
Have you previously attended Gujarati Classes?
*
Yes / No. if Yes please provide approx dates
Name of Mainstream School
*
Any Medical conditions
*
None
Diabetes
Epilepsy
Eczema
Asthma
Learning Disability
Physical Disability
Others (specify below)
Other Medical Conditions
Receipt No or Online Banking Date / Reference
*
Receipt No / Bank Reference No. Please Ensure Payment has been made in the Office or Enter the Reference Details and Date Payment was made Via Bank Transfer
ID Picture
File should be in jpg format
Online Transfer Via Bank
Account Name: Shree Lohana Mahajan CIO Sort Code: 609500 Account No: 13002210 Reference: Name of Student
Click this link for School Term Dates
Submit
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