Application Form | Kita Curumim

We offer places for Children 10-18 months old.

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 *

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