Online Registration Form
CHILD'S PARTICULARS
BC No
First Name
Last Name
Hanyu Pinyin
Nationality
Race
Date of Birth
(dd/mm/yyyy)
Present Age
Place of Birth
Gender
Female
Male
Birth Order
1st
2nd
3rd
Number of Siblings
1
2
3
4
Previous Care Arrangements
Parents
Relatives
Nanny
Childcare Centre
Others (Please specify)
Home Address
Person you authorize to pick up your child other than yourself
Name
NRIC
Relationship
Contact No in case of emergency (in the event that you or your spouse could not be reached)
Name
Telephone
Contact No of child's/family medical practitioner
Doctor
Address
Telephone
Dentist
Address
Telephone
Medical Conditions (Please state if any)
Special instructions concerning child (Please state allergies if any)
Share with us your child's habits, character traits & interests.
Preferred date of commencement
(dd/mm/yyyy)
Centre
Millenia: City Childcare Centre
Simei: Kindergarten
Childcare Session
Half day - AM
Half day - PM
Full Day
Flexi-care
Kindergarten Session
8:15am
11:30am
2:45pm
Enrichment class
Will you be using your Baby Bonus Scheme
Yes
No (Please specify)
How you came to know about Josiah Montessori
Friends
Media
Signboard
Others
FATHER'S PARTICULARS
Name as in NRIC
NRIC/Passport No
Date of Birth
(dd/mm/yyyy)
Race
Nationality
Occupation
Office Contact
Mobile
Email Address
Home Address
Home Contact
Mailing Address (if different from above)
MOTHER'S PARTICULARS
S
Name as in NRIC
NRIC/Passport No
Date of Birth
(dd/mm/yyyy)
Race
Nationality
Occupation
Office Contact
Mobile
Email Address
Home Address
Home Contact
Mailing Address
(if different from above)
Thank You for registering your child with us!
Please note that places are subject to availability. However, you can get in touch with us at +(65) 6336 6906 (childcare centre) or +(65) 6260 1312 (kindergarten) or email us at
josiah@singnet.com.sg
to check on the status of your on-line registration.
