Registration form

JDK

Below you will find the registration form and we kindly ask you to provide us with as much information as possible. This gives us the best possible indication of the child’s situation and helps us we make better connection to the child.

Fill out the registration form online

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Registration details

Date of registration

Filled in by:

Referrer:

Information child

First and last name

Date of birth (dd/mm/jj)

Address

Postcode

City/town

Telephone number

Cultural background

BSN number

Information parent(s) / guardian(s)

Name parent/guardian 1

Telephone number

E-mailaddress

Name parent/guardian 2

Telephone number

E-mailaddress

Who has authority?

Parent/guardian 1Parent/guardian 2Other

Name of other authority

Relationship to child

Address

Postcode

City/town

Telephone number

Reason for registration / request for help. Describe these as specifically and extensively as possible.

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Which school does the child attend?your full name

Current youth services

Contact person at the youthservicesyour full name

Have criminal offenses been committed in the past?

YesNo

If yes, please provide a short description

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Relevant history

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Approach/treatment

0 /

Bijzonderheden

0 /

Additional reports or documents

Upload files

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Stichting JDK’s

Naschoolse activiteiten

Door middel van het aanbieden van naschoolse sport- dans- muziek- en andere fysieksociale activiteiten vindt JDK de ingang om de deelnemers hun kwaliteiten positief te laten ervaren. Stichting JDK behandelt elk kind als uniek, en heeft ook oog voor de ondersteuningsbehoefte van elk uniek kind.

bekijk activiteiten

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