Pathshala Registration 2022-2023

JSSD - Pathshala Student Registration

Please complete the form below to enroll for Pathshala
Parent/Guardian Information
Registration Date*

MonthDayYear
Date
Name*

First NameLast Name
Email Address 1*
Parent 1's (level 1-4) or self (adult class) email address
Email Address 2*
Parent 2's (level 1-4) or Spouse's (adult class) email address
Address*

Street Address

Street Address Line 2

City

Zip Code
Phone Number*

Area CodePhone Number
Emergency Phone Number*

Area CodePhone Number
Student Information
If you don't know which level to sign up for, please pick one for now and work with pathshala coordinator/teacher later to adjust to your appropriate level.

Pathshala Teachers*:

For Kids
- Level-1 Sangeeta Vora
- Level-2 Amisha Sheth
- Level-3 Sagar Shah
- Level-4 TBD
For Adults
- Level-5 Parulben - Topics
- Level-6 Pritesh-Ami - Topics
- Level-7 Kokilaben - Topics
* Subject to change anytime

Lunch / Cleaning Signup
Note - If you need to change your selection, please uncheck your current selection before selecting another one.
Lunch And Cleaning Date (Please pick one)*
#Adults
#Students registered in Adult Class
#Minors
#Students registered in Minor Class
#Students*
Total #Students
#Seniors
Fees per Student*
Master field for Calculating Total Fees
Lunch Contribution Per Family*
Master field for Calculating Actual Lunch Contribution when selected
Cleanup Contribution Per Family*
Master field for Calculating Actual Cleanup Contribution when selected
Lunch Contribution
Registration Fees*
Total Fees*
in USD ($)
Additional Info (Allergies/Restrictions etc.)

Summary

Registration Fees Per Student	${feesPer}.00
#of Students	{students}
Student 1	{name} - {pathshalaLevel} - {languageClass}
Student 2	{name36} - {pathshalaLevel39} - {languageClass88}
Student 3	{name42} - {pathshalaLevel45} - {languageClass89}
Student 4	{name48} - {pathshalaLevel51} - {languageClass90}
Student 5	{name54} - {pathshalaLevel57} - {languageClass91}
Total Registration Fees	${registrationFees}.00
Lunch Date/Contribution	{lunchDate}
Total Fees	${payment}

Total Fees ($)*

prevnext( X )
USDJSSD - Pathshala Registration Fees for 2022-23
Note - Submit button will take you to Paypal. You can pay with credit card. No login needed.
Should be Empty:

JSSD - Pathshala Student Registration