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
Mother’s Name
Home Address:
Home Phone
Occupation
Title
Name of Company
SCHEDULE PREFERRED
SCHEDULE PREFERRED
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
Max. size: 250.0 MB
Please note, submitting an Application Form, does not guarantee enrollment into Rainbow’s World Family Child Care. Your child’s name will be put on our waiting list, and you will be notified regarding the status of your application.