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Locations
Day care
About us
- Organisation
- Policy
Contact

Locations
Day care
About us
- Organisation
- Policy
Contact

Locations
Day care
About us
- Organisation
- Policy
Contact

Application form

Location*
Parent / caregiver Please fill in the details of the parent / caregiver 1*
Name
Name
Address
Street + housenumber City Zip code
Private Phone number
Phonenumber
E-mailaddress
Date of birth*

day
month
year
BSN Number*
Parent / caregiver Please fill in the details of the parent / caregiver 2. *
Name
First name Last name
Address
Street + housenumber City Zip code
Private phonenumber
Phonenumber
E-mailaddress
Date of birth*

day
month
year
BSN Number*
Is your child vaccinated according to the National Vaccination Program / Do you plan to follow the National Vaccination Program?*
- Yes
- No
Below you can enter the details of the child
Name child
First name Last name
BSN Number*
Date of birth (expected)*

day
month
year
Do you already have children who are placed with KleintjeZuid?*
How did you find KleintjeZuid?
Preferred days 1st choice*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Preferred days second choice*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
If no preferred days, how many days?
If you register your child for after-school care, we would like to know the name of the primary school.
Starting date*
*Take into account at least three days at the desired commencement date (these are not full days)
Month
Year
signature*
Date signature*

day
month
Year
Approval*
Ja, ik agree with the privacy policy

prices

REGISTER

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Contact

KleintjeZuid Day Care & After School Care
IJsbaanpad 9-11
1076 CV Amsterdam
info@kleintjezuid.nl
General: 020 20 89 920

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