Les Lut'ain

Registration

Bonjour ☀

First name

Last name

Birthdate

Gender

?

Girl

Boy

Comment

Identification number

Arrival

Departure

Tutor

Tutor's full name

Tutor's phone number

Other phone number

Tutor's email

Identification number

Street

City

Postcode

Country

Profession

Profession category

Second tutor

Tutor's full name

Tutor's phone number

Other phone number

Tutor's email

Identification number

Street

City

Postcode

Country

Profession

Profession category

Financial Aid Eligibility Details

Dependent children

Dependent children with disability

Family income N-2

Family situation

Parent with a disability (AAH beneficiary)

Type d'accueil souhaité :

STRUCTURE

Merci d'indiquer pour quelle structure concerne votre demande

Hours of presence

Monday

Tuesday

Wednesday

Thursday

Friday

Monday

Tuesday

Wednesday

Thursday

Friday

Monday

Tuesday

Wednesday

Thursday

Friday

Monday

Tuesday

Wednesday

Thursday

Friday

Monday

Tuesday

Wednesday

Thursday

Friday

Monday

Tuesday

Wednesday

Thursday

Friday