Registration form Kralingen You must have JavaScript enabled to use this form. information mother name * surenaam initials * date of birth * Dag Dag12345678910111213141516171819202122232425262728293031 Maand Maandjanfebmrtaprmeijunjulaugsepoktnovdec Jaar Jaar196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031203220332034203520362037203820392040204120422043 bsn * nationality street & nr * zipcode * city * email * home phone * mobile phone * work phone information father name * surname initials * date of birth * Dag Dag12345678910111213141516171819202122232425262728293031 Maand Maandjanfebmrtaprmeijunjulaugsepoktnovdec Jaar Jaar196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031203220332034203520362037203820392040204120422043 bsn * nationality street & nr * zipcode * city * email. * home phone * mobile phone * work phone information child name surname date of birth * Dag Dag12345678910111213141516171819202122232425262728293031 Maand Maandjanfebmrtaprmeijunjulaugsepoktnovdec Jaar Jaar20032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031203220332034203520362037203820392040204120422043 the (expected) date of birth bsn childcare kind of childcare * toddler playgroup day-care afterschool care school name has your child already visited childcare before yes, if so what kind no previous child-care Placement wanted by * (date or asap) days number of days no preference no preference 1st choice (please tick box) mon tue wed thu fri 2nd choice (please tick box) mon tue wed thu fri 3th choice (please tick box) mon tue wed thu fri comments The fields with a * have to be filled in.
