Student NRIC

Student Name

Date of Birth

Age

Gender

Male Female

Parent NRIC

Nationality

Class Form

Year

Academy

Phone

Email

Address Line1

Address Line2

Zip Code

Member Ship Reg Fee: $55/- Fee Collected By:

Paraiyattam Kolattam/Kummi Oyilattam Kavadi Sindhu
Silambattam Lazim Dance Kudai / Visiri Kuravanji
Kavadiyattam Fusion