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FLORENTINUM
Британский дошкольный и детский сад
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введение
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Внеклассные мероприятия
контакт
Online registraTION FORM
Name - Mother*
Surname - Mother*
Local Phone - Mother *
Date of Birth - Mother*
E-mail Address - Mother*
Name - Father*
Surname - Father *
Local Phone - Father*
Date of Birth - Father*
E-mail Address - Father*
Name - Child*
Surname - Child*
Personal identification number or Passport Number - Child*
Gender - Child*
Male
Female
Permanent Address in Prague - Family*
Date of Birth - Child*
Place of Birth - Child*
Residence Status - Child*
Temporary Residence
Permanent Residence
Nationality - Child*
What languages does your child speak?*
Attendance begins
Nursery - Programmes
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Full-time programme 8:00 - 18:00
Part-time proframme 8:00 - 14:00
Nursery - Days per Week
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5 Days per Week
4 Days per Week
3 Days per Week
2 Days per Week
Preschool - Programmes
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Full-time programme 8:00 - 18:00
Part-time proframme 8:00 - 14:00
Preschool - Days per Week
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5 Days per Week
4 Days per Week
3 Days per Week
2 Days per Week
Do you request Catering Services?*
Yes
No
Does your the child sleep after lunch?*
Yes
No
Daily Routine
Dietary Restrictions
Doctor´s Name, Phone and Address*
Prescriptions Medications
Child´s Blood Type*
A
B
C
AB
O
Medical Insurance Co.*
Illness or Conditions
Alternatively, select
Asthma
Chicken pox
Ear Infestation
Fainting
Broken Bones
Diabetes
Epilepsy
Mumps
Imunization
G.M.Rubbela
Vaccination (immunization)*
Tell us more about your child
How did you hear about us?*
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Passed a Florentinum Building
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