Vedic Sanskriti School - Chicago

Vedic Sanskriti School - Chicago - Registration Form
Enter Parents Information

First Parent's data is required
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Primary Email*
Profession*
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Second Parent's Information (Optional)
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Second Parent's Profession

Class and Children information

Note you can register up to three Children in one Form submission. Tuition Donation will be $100 per Child and payable via Zelle or Credit Card.
How Many Children are you registering?*
Tuition Donation will be $100 per Student.

Please Enter Children Data
First Child Name*

First NameLast Name
First Child DOB*

MonthDayYear
Date
Second Child Name*

First NameLast Name
Second Child DOB*

MonthDayYear
Date
Third Child Name*

First NameLast Name
Third Child DOB*

MonthDayYear
Date

Student Summary and Tuition Donation Amount

You have registered following Children:

{firstChild}

{secondChild}

{thirdChild}

Total Tuition Fee will be ${totalTuition}

If this looks good, please go to next page to Pay and Submit, otherwise go back and make corrections

Total Tuition
Tuition Donation Options*

Zelle (Recommended. No fees to Samaj)Debit or Credit Card

Total Tuition Donation amount to Pay ${totalTuition}

Please scan the QR code below with your Bank Zelle App or Pay to

treasurer@aryasamajchicago.com
Confirmation*

I have made the payment via Zelle
VSS Tuition Amount to be charged*

prevnext( X )
USDDescription

Should be Empty: