Your Name (required)

Your Email (required)

Child's Information:

Last Name of Child (required)

First Name

Nick Name

Date of Birth
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Address

Gender
MaleFemale

Nationality

Religion

Family Doctor

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Information of Parent #1:

Last Name of Parent #1

First Name of Parent #1

Date of Birth, Parent #1

Address, Parent #1

Telephone, Parent #1

Cellular, Parent #1

ID Number, Parent #1

Employer, Parent #1

Occupation, Parent #1

Email, Parent, #1 (required)

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Information of Parent #2:

Last Name of Parent #2

First Name of Parent #2

Date of Birth, Parent #2

Address, Parent #2

Telephone, Parent #2

Cellular, Parent #2

ID Number, Parent #2

Employer, Parent #2

Occupation, Parent #2

Email, Parent, #2 (required)

_________________________________________________________
Other Authorized Persons ( in case of emergency):

Last Name of Other Authorized Person #1

First Name of Other Authorized Person #1

Telephone of Other Authorized Person #1

Last Name of Other Authorized Person #2

First Name of Other Authorized Person #2

Telephone of Other Authorized Person #2

_________________________________________________________
Financial information

We charge Nafl. 50 administration fee per application/child, plus a one-month deposit. When your child leaves the daycarecenter, this deposit will be used as the last payment. Before the fifth of every month, payment is due for the upcoming month, which means you pay the fee for May before the 5th of April. When you no longer want to make use of our services you need to give notice two months in advance (per the 1st or 16th of the month).

Comments

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