Aanmelding - Stichting VillaDriel

EN | NL

Registration for Stichting VillaDriel

Requested childcare

Selecteer hieronder de dagen waarop u vaste opvang nodig heeft, op de woensdag en de vrijdag is er geen TSO op de Mgr. Zwijsenschool. Indien u alleen incidentele opvang nodig heeft dan hoeft u geen dagen te selecteren of kunt u de vrijdag selecteren.

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*
Phonenumber (Incase of emergency)*

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

Nickname*
School/Classroom
Medical notes
May be picked-up by

Consent questions

Please fill with Yes or No to what applies

Wilt u de factuur jaarlijks betalen met 3% betalingskorting

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname
Last name prefix
Last name*
Relationship
Date of birth
Spoken language
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
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
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
Date of birth
Citizen number (BSN)

Street
House number
House number extension
Postalcode (numbers)
Postalcode (characters)
City
Phone number (Home)*
Mobilephone number
Phone number (work)
E-mail address

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