Admission Form

CHILD
LINGUISTIC
FAMILY
SCHEDULE
GENERAL

CHILD INFORMATION

First Name

Last Name

Date of birth

Place of Birth/Country

Home Address

City

Zip

Home Phone

LINGUISTIC INFORMATION

Native tongue of the mother

Native tongue of the father

Language spoken to the child by the mother

by the father

by a third person in the household

Language(s) spoken by the child

FAMILY INFORMATION

Father’s Name

Home Address

Home Phone

Occupation

Title

Name of Company

E-mail

Mother’s Name

Home Address:

Home Phone

Occupation

Title

Name of Company

E-mail

SCHEDULE PREFERRED

SCHEDULE PREFERRED
Regular Day (8:00 am – 4:00pm) Extended Day (8:00 am – 6:00 pm) Early Bird (7: 30 am )

GENERAL INFORMATION

Has your child had any playgroup experience, if so, where and for how long?

What benefits do you want your child to gain from this program?

How did you hear about Rainbow’s World Family Child Care?

Why are you interested in our program?

Is there any specific information the our program needs to know about your child?

Photo of your child Choose a file

Max. size: 2.0 GB

Tenga en cuenta que enviar una solicitud no garantiza la inscripción en Rainbow's World Family Child Care. Su hijo/a se incluirá en nuestra lista de espera y se le notificará sobre el estado de su solicitud.

Required
I hereby apply for admission to Rainbow’s World Family Child Care for my child and certify that the information on this application is correct and complete.

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