Recenter Application Form
It is important for us at the center to know the basic information of every learner using the space. Please ensure you provide us with accurate information. If you have any questions/concerns, feel free to reach out to us on 8931902222.
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Email *
Full name of your child *
Date of Birth *
MM
/
DD
/
YYYY
Father's Name & Occupation *
Mother's Name & Occupation *
Contact information (please include phone number and address) *
Emergency contact information (please provide at least two people's contact information - other than parents') *
How often do you/your child want to come to Recenter? *
If Part Time, which of the following days would you like to attend?
What expectations do you have from Recenter regarding your child's learning, outcomes, and experience? Please be as specific as you can. *
Any medical conditions/allergies we should know of? *
I agree to pay the registration fee of Rs. 7000/- towards the capital funds at Recenter. *
Required
I agree to pay the fees for Recenter before the 5th of every month (pre-payment) *
Required
Any other information you'd like to share with us?
Submit
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