Aanmelding - Peuteropvang Onderste Boven

EN | NL

Registration for Peuteropvang Onderste Boven

Requested childcare

De peutergroep start alleen met de dinsdagochtend en donderdagochtend (8:30 - 12:00). Andere dagen kunnen niet worden aangevraagd.

Startdate*
Enddate

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)*

Nickname
Allergies
Medication
Medical notes

Consent questions

Please fill with Yes or No to what applies

Ik geef toestemming dat de opvang informatie uitwisselt over mijn kind met de kleuterjuffen van de basisschool.*

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Nationality
Citizen Number (BSN)*
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City
Phone number (Home)
Mobile phone number*
Phonenumber (work)
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)
Highest education
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
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address
BIC/SWIFT code (if applicable)

Emergency person

Title
Initials
First name
Last name prefix
Last name
Relation

Phone number (Home)

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