Aanmelding - Stichting Kinderdagverblijf De Lelietuin

EN | NL

Registration for Stichting Kinderdagverblijf De Lelietuin

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
Country of birth
Nationality
Spoken language
Religion
Gender
Citizen number (BSN)*

Nickname
Allergies
Medication
Medical notes
Vaccinations
Health insurance
Health insurance policy number
May be picked-up by

Doctor/General practitioner
Dentist
If your Doctor/General practitioner/Dentist is not mentioned in the list, can you please write them in the remark field above?

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Country of birth
Nationality*
Spoken language
Religion
Citizen Number (BSN)*
Highest education
Profession
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*
Phonenumber (work)
E-mail address*
BIC/SWIFT code (if applicable)

Parent/Guardian 2

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Country of birth
Nationality
Spoken language
Religion
Citizen Number (BSN)
Highest education
Profession
Streetname
House number extension
Postalcode (numbers)
Postalcode (characters)
Country
Phone number (Home)
Mobile phone number
Phonenumber (work)
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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