Pre-Registration Form
* Required
Given name of child
*
Your answer
Surname of child
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
MA 10 Kundennummer
Your answer
Social security number
Your answer
Address
*
Your answer
Town
*
Your answer
Postcode/Zip/PLZ
*
Your answer
Phone no.
*
Your answer
Email
*
Your answer
Nationality
*
Your answer
Child's language(s) spoken (in order of fluency)
*
Your answer
Mother's name
*
Your answer
Mother's nationality
*
Your answer
Place of work
Your answer
Work tel. no.
Your answer
Father's name
*
Your answer
Father's nationality
*
Your answer
Place of work
Your answer
Work tel. no.
Your answer
Siblings (names and ages):
Your answer
Health insurance
Your answer
Special dietary requirements or allergies
Your answer
Vaccinations and immunisations
Your answer
Previous schools attended (if any)
Your answer
Proposed month of entry
Your answer
Where did you hear about us?
Your answer
Comments
E.g. what are the reasons why you would like your child to go to The Children's House? Or any other information you want to add.
Your answer
Privacy/Security Note: The Children's House will not voluntarily sell or give out any information submitted by the user to third parties.
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