KIDS opvang G.O.B. Nederland

Regio Putten en omstreken

 

 

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Bent u WA verzekerd?                                                                                              ja/nee

 

Omschrijving samenstelling gezin:

 

inwonende kinderen:                                geb.datum:        j\m       school:

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Zijn er bijzondere omstandigheden in uw gezin:

                                                                                                                                             

                                                                                                                                             

 

Opleiding ervaring met kinderen:

                                                                                                                                             

                                                                                                                                             

 

Heeft u voorkeur voor bepaalde opvang tijden?

Wilt u uw voorkeur met X aangeven?  De tijden dat u perse niet kunt graag aangeven met N.

 

Maandag                0     ochtend            0     middag            0                na schooltijd

Dinsdag                  0     ochtend            0     middag            0                na schooltijd

Woensdag              0     ochtend            0     middag            0     na schooltijd

 

 

Donderdag             0     ochtend            0     middag            0     na schooltijd

Vrijdag                   0     ochtend            0     middag            0                na schooltijd

Zaterdag                0     ochtend            0     middag            0                na schooltijd

Zondag                   0     ochtend            0     middag            0     na schooltijd

 

 

Heeft u voorkeur voor een bepaalde leeftijdsgroep?

                                                                                                                                             

                                                                                                                                             

 

 

Hoeveel kinderen wilt u opvangen?

                                                                                                                                             

                                                                                                                                             

 

 

Wat stelt U zich voor bij gastouderopvang?

                                                                                                                                             

                                                                                                                                             

 

 

Hoe kwam U in contact met het gastouderbureau?

                                                                                                                                             

                                                                                                                                             

 

 

Bent u bereid als noodopvang in ons bestand te worden opgenomen? ja/nee

 

 

Opmerkingen:

                                                                                                                                             

                                                                                                                                             

 

 

Datum  :                                                    naam :                                                                        

 

 

 

Handtekening  :