Aanmelding - Chr. PSZ. De Flierefluiter - Merwedestraat24

EN | NL

Registration for Chr. PSZ. De Flierefluiter - Merwedestraat24

Requested childcare

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*
Phonenumber (Incase of emergency)

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

Nickname
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*

Parent/Guardian 2

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Nationality
Spoken language
Citizen Number (BSN)
Highest education
House number extension
Country
Phone number (Home)
Mobile phone number
E-mail address

Emergency person

Title
First name
Last name prefix
Last name
Relation

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

Privacy Statement