Application Form :: Dráček a Lvíčata

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APPLICATION FORM for enrolling a child in nursery school

The data are confidential pursuant to Act No. 256/1992 Coll., On the protection of personal data in information systems, Act No. 106/1999 Coll., On Free Access to Information Act No. 101/2000 Coll., On the protection of personal data and on the amending c

Child's name: * Child's last name: * Date of birth of the child: * Place of birth: * Personal ID of the child: Address (Street, č.p, zip code, town): * Mother tongue: * Citizenship: * Child's Health Insurance: * Enroll to kindergarten from: *

For: *

Full-day attendance

Half-day attendance

From (time): * Until (time): * Name and surname of the father: * Phone number: * E-mail *

Employer of father (address, phone number): *

Name and surname of the mother: * Phone number: * E-mail *

Employer of mother (address, phone number):

unemployed

on maternity leave

will be return to work

Siblings (names, dates of birth):

We undertake to immediately announce a nursery school teacher incidence of the disease in the portable family or near the child, the child's disease transmissible disease or disease of the person with whom the child has come into contact with: *

Yes

Place: * Date: *

APPLICATION FORM for enrolling a child in nursery school

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