Provisional Enrolment Children Children Surname, First Name(s) Date of birth Native Language Nationality Mother Mother Father Father Surname, First Name(s) Surname, First Name(s) Street Street Postal Code, Town Postal Code, Town Occupation Occupation Employer Employer Date of birth Date of birth Native Language Native Language Nationality Nationality Telephone / mobile (daytime) Telephone / mobile (daytime) Telephone / mobile (evening) Telephone / mobile (evening) E-mail E-mail Notes Desired entry date New Field New Field Group 0 – 3 years Desired days (min. 3 days) Desired days (min. 3 days) Monday Tuesday Wednesday Thursday Friday New Field New Field Group 3 – 6 years The registration fee of CHF 800.00 is due after MIC GmbH confirmed the child’s acceptance. The registration fee of CHF 800.00 is due after MIC GmbH confirmed the child’s acceptance. I hereby agree that my details may be collected and processed in order to answer and execute the request. 7 + 13 = Send
