Aanmelding - Chr. PSZ. De Flierefluiter - Pauwtjesmolen 24

EN | NL

Registration for Chr. PSZ. De Flierefluiter - Pauwtjesmolen 24

Requested childcare

Locatie Pauwtjesmolen is [vooralsnog] alleen geopend op maandagochtend en donderdagmiddag. Wilt u bij de einddatum invullen wanneer uw kindje 4 jaar wordt.

Startdate*
Enddate*

Toddlercare in the morning (PO) Monday Tuesday Wednesday Thursday Friday

Toddlercare in the afternoon (PO) Monday Tuesday Wednesday Thursday Friday

Remark

Child

You will be able to register another child after submitting the first registration

Initials*
First name*
Last name prefix
Last name*

Date of birth*
Estimated date of birth / Not yet born
Nationality
Spoken language
Gender
Citizen number (BSN)*

Medical notes
May be picked-up by

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Nationality
Spoken language
Citizen Number (BSN)*
Reffered for VVE (Preschool education)
Personal situation*
Combined income
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
Country
Phone number (Home)
Mobile phone number
E-mail address*
IBAN*
BIC/SWIFT code (if applicable)

Parent/Guardian 2

Title
Initials
Firstname*
Last name prefix
Last name*
Relationship
Date of birth
Nationality
Spoken language
Citizen Number (BSN)*
If you do not enter an address here, the address of parent/guardian 1 will be automatically taken over.
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
Country
Phone number (Home)
Mobile phone number
E-mail address
BIC/SWIFT code (if applicable)

Emergency person

Title
First name
Last name prefix
Last name
Relation

Phone number (Home)
Mobilephone number
Phone number (work)

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