Prijava dječji vrtić Zvjezdica - Croatian American Society

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LITTLE STAR KINDERGARTEN
ENROLLMENT 2019

Mother's Namefull name

Occupation & Company

Father's Namefull name

Occupation & Company

Child's Namefull name

Child's Date of Birth

Childs Place of Birth

Child's Citizenship

Current Address

Language spoken at home

Current Phone

Permanent Address

Permanent Phone

Email AddressMother

Email AddressFather

Other Contacts(please state which):

Does your child have any allergies / require regular medication / have a specific diet, or have any other medical or health related requirements?

YesNo

If yes, please provide further information:

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Has your child previously attended a kindergarten or playschool?

YesNo

If so, when and where?

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How did you find out about the “Little star kindergarten”?

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Today's Date

I hearby acknowledge my acceptance of the terms and conditions of enrolloment at Croatian American Society.