EuroKids Book Club Membership Form

Yes, I understand the EuroKids Book Club is a real wealth of knowledge and would like to enroll my child as a member for one academic year.
Name of child: Name of parent: Mailing Address:

______________________________________________________ ___________________________________________________
: : : : : : :
Note: Please fill up all fields of information. Please fill information in CAPITAL LETTERS only.

Photograph

House No. Name of Apartment/Building/House Street Name Landmark Town / City State Pin Code

Admission form
Date of Admisssion:______/______/_______/ (dd/mm/yy) Admission sought in: PlayGroup Nursery EuroJunior EuroSenior Time Slot (Batch) Preferred: ________________________________________
Yes No

Tel. no. (Res): ____________________ Mobile no: +91 _____________________

Is the child a member of any book library or any such book club

If yes, please mention the name of the same _______________________________

Particulars of the child

Name: _______________________ Surname: _______________________ Name used at home: _____________________

Signature of Parent: ______________________

Would you like to gift/recommend a EuroKids Book Club membership to anybody else? If yes, to whom? Name:

Sex:

Male

Female

Nationality: _________________

__________________________________________________________
: : : : : : :

Date of birth: _____/ _____/ _____/ (dd/mm/yy) Age: Years: _______ Months: ______ Days: ______
Residential Address: House No. Name of Apartment/Building/House Street Name Landmark Town / City State Pin Code Language(s) spoken at home: : : : : : : : English Hindi Others ____________

Mailing Address:

House No. Name of Apartment/Building/House Street Name Landmark Town / City State Pin Code

Tel. no. (Res): ____________________ Mobile no: +91 _____________________

Particulars of Parents / Guardian

I) Father / Guardian ! ! ! ! ! ! ! Name: _____________________________
Educational Qualifications: Under Graduate Graduate Post Graduate

EuroKids Book Club Subscription

Book Club

Benefits for EuroKids Book Club Members

Each member will receive 6 fantastic books each academic year at no cost. Each member will receive 3 comprehensive book catalogues in a year, which will provide information about loads of delightful books at affordable prices and even book reviews. The books in the catalogue will be selected by a panel of educationists, children's book authors and a special panel consisting of Pre-School children too. Books selected from the catalogue will be shipped to the member's address

Occupation:

Service

Business

Public Services

Name of the Organisation:____________________________________ Tel. No.: [STD Code] ____________ [Res] ________________________ [STD Code] _________[Off.] ____________[Mob.] __________________ Email address: ________________________________

II) Mother
absolutely free of cost.

! ! ! ! ! !

Name: _____________________________
Educational Qualifications: Under Graduate Graduate Post Graduate

A variety of payment options cheque/demand draft/cash on delivery/credit card. Rewards scheme Earn more rewards with every purchase. Reading was never so rewarding! Special book reading sessions at EuroKids Pre-Schools and/or bookstores. A plethora of special offers and other benefits from time to time.

Occupation:

Home maker

Service

Business

Public Services

Tel. No.: [STD Code] ____________ [Res] ________________________ [STD Code] _________[Off.] ____________[Mob.] __________________ Email address: ________________________________

Book Club Basics

One time registration fee of INR 50/Club fees of INR 425/- (amount to be paid along with annual Pre-School fees).

Previous schooling:

Yes

No
An additional Membership Form to be filled by the parent with the EuroKids Admission Form After registration and payment of fees, membership will be accorded to the child. Each member will subsequently get a membership kit consisting of: A Membership Card Six fantastic books totally at no cost (To be sent in 3 dispatches) The first catalogue

If yes, please specify: ______________________________________________ Is your child toilet-trained? Yes No

How many siblings does the child have? Brothers (mention age) 1. _________2. _________3. _________ Sisters (mention age) 1. _________2. _________3. _________

Parent Resource Subscription

The parent resource section on the EuroKids website will cover:
Parenting resources Expert views School search Activity centre (downloads & printables) Polls Pre-School interface Recipes

Has any of the child's kin attended EuroKids before:

Yes

No

If yes, which branch __________________ which year ___________________

Contests

EuroKids Pre-School search

Medical Record
Blood Group: ______________

Community building through message & discussion boards

The topics will be refreshed every fortnight.

I) Immunisation History:
Vaccination Age (0-2 weeks) (6-24 weeks) (6 doses) (8-9 months) (15-18 months) (4-6 years) (upto 24 weeks) Under 1 year after 1 year of age after 2 years of age after 1 year of age Yes (a ) No(a )

Annual subscription charges for the website - INR 90/-

a) BCG On subscription to the service; you will receive the User Name & Password to access the section on www.eurokidsindia.com This information will be sent to the registered e-mail address given by the parent in the admission form. The subscription will be valid till the end of the academic year. b) DPT (I, II, III) c) Oral Polio Vaccine (OPV) d) Measles e) MMR f) DT g) HBV - Hepatitis (I,II,III) h) Hi B (Meningitis-3 doses) Dear Administrator, I wish to avail of the Parent Resource Subscription for getting access to the resource section on the EuroKids website. Please enroll me for the same. My details are as given below.
Name of parent: Name of child: Program: Email address:

i) Chicken Pox j) Typhoid k) Hepatitis A (2 doses)

Note:
! Vaccines (a) to (g) are compulsory (h) to (k) are optional, but recommended once a year. !

____________________________________________________ ____________________________________________________ _ Playgroup Nursery EuroJunior EuroSenior

II) History of past illness:

_____________________________

Specific ailments suffered in the past: _____________________________

! Surgery undergone (if any): _____________________________________

Signature of Parent:

! Allergy (if any): ________________________________________________

Does your child suffer from any phobias? Yes No If yes, please specify: ______________________________________________ Yes No Is the child presently on any regular medication? If yes, please specify: ______________________________________________ Any special instructions: ________________________________________________________________ ________________________________________________________________

Parent SMS Subscription

Please fill up the below-mentioned SMS subscription form and hand it over to your respective EuroKids Pre-School administrator. Once the service is activated, you will receive regular updates from your EuroKids Pre-School. Please check the cost of

subscription for the Parent SMS facility with your Pre-School. These updates can be about Special Announcements

Declaration of Parent / Guardian

I declare that the information given is correct and complete and I have not withheld any information. I agree to entrust my child under the care of the staff at EuroKids. I shall not hold EuroKids responsible for any unavoidable mishap or accident. I have read through The EuroKids Pre-School policies and am in agreement with the said policies. Signature: ____________________ Date: ________________________

Reminders Alerts

This service will be active till the time that your child is enrolled with EuroKids Pre-School in a given academic year. In case you wish to stop these updates, you can unsubscribe by sending an SMS STOP EKSMS to 56677

Dear Administrator, I wish to avail of the SMS facility for receiving messages from EuroKids Pre-School. Please enroll me for the facility and my details are as given below.

Fee Details
(To be filled in by office staff) Registration Fees : Tution Fees Annual Charges Library Fees Library Deposit : : : : Rs. _______________ Half yearly : Rs. ________ Yearly : Rs. ________ Rs. _______________
Program: Mobile no: Name of child: Name of parent:

____________________________________________________
(We would prefer the mother's name & mobile number if available)

+91 ______________________ _____________________________________________________ Playgroup Nursery EuroJunior EuroSenior

Rs. _______________ Rs. _______________ Signature of Parent: ____________________