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A Place for Young Minds to Embrace Nepalese Heritage

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1 Student

2 Medical

3 Parents

Student Information

Student First Name *

Student Last Name *

Gender *

Date of Birth *

Current School Name *

Current School Year *

Your Suburb *

Choose Nearest School *

Medical Information

Allergies * YesNo

If you selected 'Yes' in Allergies, please mention

Your Child's General Practitioner's Name *

General Practitioner's Address *

General Practitioner's Phone Number *

Parent/Guardian Information

Parent/Primary Carer 1

Full Name *

Relation

Mobile Number *

Email *

Parent/Carer 2

Full Name *

Relation

Mobile Number *

Email *

Emergency Contact (Other than Parent/Carer)

Full Name *

Relation

Mobile Number *

By signing below, I confirm that I have read and understand the laws that protects the interests of my child as mentioned above. I understand that my child's personal and educational information shall be stored in the school's database and information shall be limited to the school's staff, employees, teachers or the management.

1 Student

2 Medical

Student Information

Student First Name *

Student Last Name *

Current School Name *

Current School Year *

Your Suburb *

Choose Nearest School *

Medical Information

Allergies * YesNo

If you selected 'Yes' in Allergies, please mention

Your Child's General Practitioner's Name *

General Practitioner's Address *

General Practitioner's Phone Number *

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Start your journey with Pathshala Australia today and help your child connect with their heritage through language.

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