Victoria | 10317 Berlin |

* Mandatory fields

Child's data

First name*

Last Name*

Gender*

Date of birth*

Format: DD.MM.YYYY

Place of birth*

Nationality:*

Primary language spoken at home*

Recommended by

Desired enrolment date*

Format: DD.MM.YYYY

Start date flexible

Siblings

Others

Additional services (please select)

alleinerziehend (Nachweis)

besucht z.Zt. eine andere Kita

gültiger Gutschein vorhanden

Integrationskind

Migrationshintergrund (nicht deutscher Herkunft - Nachweis Gutschein)

Quartiersmanagement (Nachweis Gutschein)

Sprachförderung

Your details/details of primary contact

Gender*

First Name*

Surname*

Email address*

Phone*

Street and house number*

Zipcode *

Location:*

Denomination*

Nationality:*

First language*

Type of parent/guardian*

Job / Profession

Details of secondary contact person

Gender*

First name*

Surname*

Email address*

Phone*

Street and house number*

Zipcode *

Location*

Denomination*

Nationality:*

Native language*

Type of parent/guardian*

Job / Profession

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