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 $50 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 NameMiddle NameLast Name
Mothers Full Name:

First NameMiddle NameLast 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

CityState / Province

Postal / Zip Code
How many child/children attending Pathshala?*

123
Children/s Information >

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

First NameMiddle NameLast Name
Child-1 School Grade
Child-1 Pathshala Level
Child-1 Gender

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

First NameMiddle NameLast Name
Child-2 School Grade
Child-2 Pathshala Level
Child-2 Gender

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

First NameMiddle NameLast Name
Child-3 School Grade
Child-3 Pathshala Level
Child-3 Gender

MaleFemale
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!
Note: You will receive your donation receipt via email. Transaction Fee $1.99 will be added to the donated amount.

Once you submit your details, we will contact you if we have any questions.

Thank you for your support to JSGA.
Total amount due:*

prevnext( X )
USDJSGA Pathshala registration

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

JSGA Pathshala Registration

Children/s Information >