Registration form for children

School year

POLSKA SOBOTNIA SZKOŁA IM. KAZIMIERZA PUŁASKIEGO

Child's last name

Child's birth date

Child's first name

Parents / guardians first name

Parents / Guardians first name

Parents / Guardians last name

Cell phone number 1 (optional)

Email

Cell phone number 2 (optional)

Address (house number, street, city, zip code)

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Contact in case of emergency (first and last name, phone number)

Child's fluency in Polish language (mark applicable)

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Comments and information regarding child's health (i.e. alergies) (optional)

How would you like to help our school (select options below) (optional)

    My contact information may be published on the school roster

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Clicking on "Submitting form" will send it automatically to our mail address