| Mother's
name: |
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| Registered:
(Mantalsskriven) |
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| Nationality: |
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| Address: |
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| Ph (home): |
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| Ph (work): |
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| E-mail: |
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| Father's
name: |
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| Registered:
(Mantalsskriven) |
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Nationality: |
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| Address: |
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| Ph (home): |
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| Ph (work): |
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| E-mail: |
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| Childs name: |
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| Sex: |
Male
Female |
Birthdate:
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| Siblings: names and
birthdates: |
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| In which municipality do
you live? |
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Resident
in Sweden since (yr/month):
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How
permanent is your residence in Stockholm?
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How much
English is spoken at home?
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When
would you like your child to start at the nursery?
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What
hours do you wish your child to attend the nursery?
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Would you
be interested in your child joining the Toddler Group? (This entails
being prepared to host the group in your home) Yes
No
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What do
you want the nursery to give your child?
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What
special needs, if any, does your child have? ( educational,
physical,emotional, medical,nutritional, etc)
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In what
way do you feel you can contribute to the running of the nursery and
its association?
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| Additional comments: |
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Parents
signature (date):
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For further information please contact Lotten
Byrne (Admissions Coordinator) by e-mail: lotten.byrne@hotmail.com
.Please return this form to Admissions Coordinator, Humpty Dumpty
Nursery, Karlaplan 19 B, 115 20 Stockholm. Currently there are no
vacancies in either the main nursery or Toddler group.
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For board
use:
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Application
received:
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Board
meeting:
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Reactivated:
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