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Gegevens ouder
Title
Mr.
Mrs.
First name
Last name
Address
Postal code
City
Mobile phone number
Phone number (home)
Phone number (work)
Email
Gegevens kind
First name
Last name
Gender
Boy
Girl
Unknown
Date of birth
Opvang
Desired care
Full day care - 8 a.m. to 6 p.m.
Half day care - 8 a.m. to 1 p.m.
Half day care - 1 p.m. to 6 p.m.
Evening care - 6 p.m. to midnight
Overnight care - midnight to 6 a.m.
Flexible care - 6 a.m. to 6 p.m.
Desired days (if known)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Number of hours (minimum of 10)
For how many children are you seeking care?
1
2
3
4
5
Overige informatie
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