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9180 Pond Mill ct. Glen Allen ,VA 23060

                                            Richmond Marathi Shala 

Child’s Name :    

                                    Last Name        First Name      Middle Name

Child’s Name in Marathi :-

Address :

City :                                                          Zip :

Birth Date  (mm/dd/yy)  :

E-mail address :

Phone :  Home : 

        Mom Cell :

         Dad Cell :

Mother’s Name :

Father’s  Name :

Parent Participation:  Assistant Teacher  res form   Substitute Teacher  res form    Shloka res form

                Checking Homework  res form   Car-pooling  res form    Story reader  res form

 Others? Describe :

Parent’ s Signature :                                               Date: