Vahan & Anoush Chamlian Armenian School

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Name of Child:*

Child's Date of Birth:*

Father's Contact Informaton:

Father's First Name:*

Father's Last Name:*

Father's Email:*

Father's Mobile Phone:*

Home Phone:

Mother's Contact Information:

Mother's First Name*

Mother's Last Name:*

Mother's Email:*

Mother's Mobile Phone:*

Home Phone:

Home Address:

Street Address*

City*

State*

Zip/Postal*

Armenian Language:*

Eastern Armenian

Western Armenian

School Presently Attending:*

Sisters/Brothers Presently Attending Chamlian:

References:

I understand that this is not a registration form, and that it does not guarantee a place at Chamlian Armenian School.*

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