Application Form - Kita Curumim

The fields marked with * are required.

Preferred Group *

German-English
German Portuguese

Requested Starting Date *

Personal Data of the Child

Name *

First

Middle

Last

Date of Birth *

Gender *

Nationality(ies)

First Nationality *

Second Nationality

Third Nationality

Mother Language *

Second Mother Language

Other Mother Language *

Please specify “Other mother language”

Siblings *

Yes
No

Age of first sibling *

Gender *

Twin *

Yes
No

Age of second sibling

Gender

Age of third sibling

Gender

Personal Data of Parents

Parent 1

Name *

First

Last

Address *

Strasse

Stadt

PLZ

Mobile Phone Number *

Home Phone Number

Business Phone Number

E-Mail *

Email

Confirm Email

First Nationality *

Second Nationality

Third Nationality

Working Status *

Profession

Number of Weekly Working Hours *

Other Working Status

Please specify “other working status”

Parental Leave

Yes
No

For how long?

Single Parent

Yes
No

Parent 2

Name

First

Last

Address

Strasse

Stadt

PLZ

Mobile Phone Number

Home Phone Number

Business Phone Number

E-Mail

Email

Confirm Email

First Nationality

Second Nationality

Third Nationality

Working Status

Profession

Number of Weekly Working Hours

Other Working Status

Please specify “other working status”

Parental Leave

Yes
No

For how long?

Single Parent

Yes
No

Who is the legal guardian? *

DSGVO-Consent *

I agree that the provider of the Kita Curumim, Imbradiva e.V., stores and processes my submitted information so that my request can be checked and answered. You can find more details in our privacy policy.

Optional

I agree that the provider of the Kita Curumim, Imbradiva e.V., stores my submitted information until the child is 7 years old, in case of interest in a potential spot in Imbradiva’s kindergarten.