Parents' name*

Child's name*

Date of birth*

Address*

Tel. Home / work*

E-mail*

We are applying for a

1. Full time 100% (7.00-16.30)2. Four days 80% (7.00-16.30)3a. 27h/week 60% (Mon-Fri 8.00-13.25)3b. 3 days a week 60% (7.30-16.30)

place at Jacob’s Kindergarten ry from