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Registration
Nederlandstalig inschrijfformulier / Registration form translated to Dutch
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Child
Initials
+ First name
Prefix + Lastname
Gender
Boy
Girl
Unknown
Date of birth or due date
BSN
Nationality
Choose nationality
English
Dutch
Belgian
German
French
Polish
American
Armenian
Bosnian
Congolese
Croatian
Czech
Cuban
Egyptian
Eritrean
Surinamese
Indian
Iraqi
Italian
Kenyan
Moroccan
Pakistani
Panamanian
Portuguese
Somali
Stateless
Sri Lankan
Swedish
Syrian
Thai
Turkish
Vietnamese
Canadian
Hungarian
Otherwise...
Desired placement
Care type
Select a care type
Daycare
Preschool
De Vrolijke Vis
Preferred starting date
Remarks
Age
from 0 to 4 years
Childcare days
Scroll right for more options
All day
07.30 - 18.30
All day
Monday
Mo
Tuesday
Tu
Wednesday
We
Thursday
Th
Friday
Fr
Age
from 2 to 4 years
VVE indication
Yes
No
Morning
8.30 - 12.30
Scroll right for more options
Monday
Tuesday
Wednesday
Thursday
Friday
Afternoon
13.30 - 17.30
Scroll right for more options
Monday
Tuesday
Wednesday
Thursday
Friday
School
Select a school
Other...
Morning
Scroll right for more options
Monday
Tuesday
Wednesday
Thursday
Friday
Afternoon
Scroll right for more options
Monday
Tuesday
Wednesday
Thursday
Friday
1st parent / carer / contractor
Initials
+ Firstname
Prefix + Lastname
Gender
Male
Female
Date of birth
BSN
Civil status
Select civil status
Married
Cohabiting
Divorced
Single
Registered partnership
Unmarried
Widow
Which language do you speak at home?
You are...
Select
(self-)employed, freelancer, artist, etc
following a course or an integration program
following a trajectory at the UWV (Dutch Employee Insurance Agency) or through your ex-employer
unemployed
Nationality
Select a nationality
Afghaanse
Amerikaanse
Armeense
Belgische
Bosnische
Bulgaarse
Canadese
Chileense
Chinese
Colombiaans
Congolees
Costaricaanse
Cubaanse
Deense
Duitse
Egyptische
Engelse
Eritrese
Ethiopische
Franse
Hongaarse
Ierse
Indiase
Indonesische
Iraakse
Iraans
Israëlische
Italiaanse
Japanse
Kenyaanse
Kroatische
Liberiaanse
Marokkaanse
Nederlandse
Oegandese
Oekraïense
Pakistaanse
Panamese
Peruaanse
Poolse
Portugese
Roemeense
Somalische
Spaans
Sri Lankaanse
Staatloos
Surinaamse
Syrische
Thaise
Tsjechische
Turkse
Venezolaans
Vietnamese
Zuid-Afrikaanse
Zweedse
Anders...
Street
+ House number
+ Suffix
Postal code
+ City
Phone number
E-mailaddress
Relationship to the child
Choose a relation
Mother
Father
Stepmother
Stepfather
Foster mother
Foster father
Grandmother
Grandfather
Aunt
Uncle
Niece
Nephew
Sister
Brother
Stepsister
Stepbrother
Friend (female)
Friend (male)
Other...
The questions below are related to a possible participation in a pre-school route.
Education
Kies een opleidingsniveau
Unknown
No education
Elementary school
Primary education
Secondary education
Higher education
University
Other...
Name of education
Place of education
Diploma
+ Year
Yes
No
What is your profession?
Do you work in employment?
Yes
No
Do you have your own company?
Yes
No
Are you a student?
Yes
No
Do you receive a student loan?
Yes
No
Are you following a reintegration process?
Yes
No
Are you following an integration course?
Yes
No
Benefit
Yes
No
If so, what kind of benefit?
If so, what start date?
2nd parent / carer
Initials + Firstname
Prefix + Lastname
Gender
Male
Female
Date of birth
BSN
Civil status
Select civil status
Married
Cohabiting
Divorced
Single
Registered partnership
Unmarried
Widow
Which language do you speak at home?
You are...
Select
(self-)employed, freelancer, artist, etc
following a course or an integration program
following a trajectory at the UWV (Dutch Employee Insurance Agency) or through your ex-employer
unemployed
Nationality
Select a nationality
Afghaanse
Amerikaanse
Armeense
Belgische
Bosnische
Bulgaarse
Canadese
Chileense
Chinese
Colombiaans
Congolees
Costaricaanse
Cubaanse
Deense
Duitse
Egyptische
Engelse
Eritrese
Ethiopische
Franse
Hongaarse
Ierse
Indiase
Indonesische
Iraakse
Iraans
Israëlische
Italiaanse
Japanse
Kenyaanse
Kroatische
Liberiaanse
Marokkaanse
Nederlandse
Oegandese
Oekraïense
Pakistaanse
Panamese
Peruaanse
Poolse
Portugese
Roemeense
Somalische
Spaans
Sri Lankaanse
Staatloos
Surinaamse
Syrische
Thaise
Tsjechische
Turkse
Venezolaans
Vietnamese
Zuid-Afrikaanse
Zweedse
Anders...
Street + House number + Suffix
Postal code + City
Phone number
E-mailaddress
Relationship to the child
Choose a relation
Mother
Father
Stepmother
Stepfather
Foster mother
Foster father
Grandmother
Grandfather
Aunt
Uncle
Niece
Nephew
Sister
Brother
Stepsister
Stepbrother
Friend (female)
Friend (male)
Other...
The questions below are related to a possible participation in a pre-school route.
Education
Kies een opleidingsniveau
Unknown
No education
Elementary school
Primary education
Secondary education
Higher education
University
Other...
Name of education
Place of education
Diploma + Year
Yes
No
What is your profession?
Do you work in employment?
Yes
No
Do you have your own company?
Yes
No
Are you a student?
Yes
No
Do you receive a student loan?
Yes
No
Are you following a reintegration process?
Yes
No
Are you following an integration course?
Yes
No
Benefit
Yes
No
If so, what kind of benefit?
If so, what start date?
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