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Mini-Vous
Registration
Ce formulaire de pré-inscription n'est pas engageant et ne garantit pas une place en structure.
Mais il est indispensable afin de rentrer dans la liste d'attente.
Nous reviendrons vers vous dès que possible.
First name
Last name
Birthdate
Gender
?
Girl
Boy
Comment
Identification number
Arrival
Departure
Tutor
Tutor's full name
Tutor's phone number
🇳🇱 +31
🇧🇪 +32
🇫🇷 +33
🇪🇸 +34
🇵🇹 +351
🇱🇺 +352
🇮🇹 +39
🇨🇠+41
🇩🇪 +49
Other phone number
🇳🇱 +31
🇧🇪 +32
🇫🇷 +33
🇪🇸 +34
🇵🇹 +351
🇱🇺 +352
🇮🇹 +39
🇨🇠+41
🇩🇪 +49
Tutor's email
Identification number
Street
City
Postcode
Country
Luxembourg
France
Belgium
Germany
Second tutor
Tutor's full name
Tutor's phone number
🇳🇱 +31
🇧🇪 +32
🇫🇷 +33
🇪🇸 +34
🇵🇹 +351
🇱🇺 +352
🇮🇹 +39
🇨🇠+41
🇩🇪 +49
Other phone number
🇳🇱 +31
🇧🇪 +32
🇫🇷 +33
🇪🇸 +34
🇵🇹 +351
🇱🇺 +352
🇮🇹 +39
🇨🇠+41
🇩🇪 +49
Tutor's email
Identification number
Street
City
Postcode
Country
Luxembourg
France
Belgium
Germany
Add a tutor
Financial Aid Eligibility Details
Dependent children
Dependent children with disability
Family income N-2
Family situation
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Civil Partners
Partners
Widow/Widower
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Divorced
Parent with a disability (AAH beneficiary)
J'élève mon enfant seul
Jumeaux
A déjà un frère ou une sœur dans la crèche
Emploi du premier tuteur
Lieu de travail du premier tuteur
Date de naissance du premier tuteur
Emploi du Deuxième tuteur
Lieu de travail du deuxième tuteur
Date de naissance du deuxième tuteur
Type d'accueil souhaité
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Régulier
Occasionnel
D'urgence
Horaires variables
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oui
non
Commentaires/questions
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Friday
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Monday
Tuesday
Wednesday
Thursday
Friday
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Monday
Tuesday
Wednesday
Thursday
Friday
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Monday
Tuesday
Wednesday
Thursday
Friday
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