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* Mandatory fields
Child's data
First name
*
Last Name
*
Gender
*
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male
female
diverse
Unknown
Date of birth
*
Format: DD.MM.YYYY
Recommended by
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Internet
keine Angabe
Print
Sonstiges
Veranstaltungen
Desired enrolment date
*
Format: DD.MM.YYYY
Start date flexible
Others
Profile image
Additional services (please select)
Alleinerziehend/ alleiniges Sorgerecht
Alleinerziehend/getrennt erziehend/ geteiltes Sorgerecht
Ganztagsplatz Kiga
Integrationskind
Krippenplatz
Migrationshintergrund
Sprachförderung
Verlängerte Öffnungszeiten Kiga
Your details/details of primary contact
First Name
*
Surname
*
Email address
*
Phone
*
Street and house number
*
Zipcode
*
Location:
*
Employer
*
Details of secondary contact person
First name
*
Surname
*
Email address
*
Phone
*
Street and house number
*
Zipcode
*
Location
*
Employer
*
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