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* Mandatory fields
Child's data
First name
*
Last Name
*
Gender
*
-- Please Select --
male
female
diverse
Unknown
Date of birth
*
Format: DD.MM.YYYY
Recommended by
-- Please Select --
Internet
Print
Sonstiges
Veranstaltungen
Desired enrolment date
*
Format: DD.MM.YYYY
Start date flexible
Desired care type
*
-- Please Select --
Hort
Kindergarten
Others
Bitte wählen Sie die gewünschten Betreuungszeiten*
Monday
from
Until
Tuesday
from
Until
Wednesday
from
Until
Thursday
from
Until
Friday
from
Until
Additional services (please select)
Alleinerziehend
Integrationskind
Migrationshintergrund
Sprachförderung
Your details/details of primary contact
Gender
*
-- Please Select --
male
female
diverse
Unspecified
First Name
*
Surname
*
Email address
*
Phone
*
Street and house number
Zipcode
Location:
*
Type of parent/guardian
*
-- Please Select --
Mother
Father
Nanny
Spouse (m) of mother
Spouse (f) of father
Spouse (f) of mother
Spouse (m) of father
Foster mother
Foster father
Stiefmutter
Stiefvater
Grandfather
Grandmother
Sister
Brother
Aunt
Uncle
Friends
Other
Job / Profession
Files
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