Student Information

Name of the student:________________________

Age:______________________

Grade:_______________________

Hindi Level: Please specify beginner, intermediate or advanced

Speaking:_____________________

Writing and recognition of the alphabet:_________________________

Parental Information

Parental Contact Name: ______________________________

Residential Address: _________________________________

Phone Number:_____________________________

Email Address:_____________________________

Would the parent be available to volunteer in the class(yes/ No)?

Please note that starting this Fall the classes are being held three times per month.

See list of students for each group.

A registration fee of $25 dollars per Year per child will be required for this registration to be valid. The registration fee will cover the cost of supplies, photocopying, reading material etc.

Please make the Ck payable to the ASNJ and give it to the teacher or contact respective coordinator.

Atul Prakash 973 239 2920

Ratna Rajpurohit 973 831 6530

Anita Shrivastava 201 445 0380