Child's Particulars

Name of Child	:
Date of Birth	:		/		/			Sex	:	M / F
		dd		mm		yyyy
Birth Cert No.	:							Child's ID	:	Citizen PR Foreigner

Parents' Particulars

Name of Father	:		Off Tel No.		Hp/Pg. No.
Name of Mother	:		Off Tel No.		Hp/Pg. No.
Home Tel No.	:
Email	:

Address

:

S'pore

1)	Are you our NTUC Childcare Shareholder?	Yes	No
2)	Are you a member of the NTUC Affiliated Unions?	Yes	No
3)	Have you registered your child with any of our centres before? If yes, fill in the details below :-	Yes	No

Name of our Centres

:

	Date of Registration	:		/		/
			dd		mm		yyyy

4)	How did you get to know about NTUC Childcare?
	Advertisement in The Straits Times	Advertisement in Lianhe Zaobao
	Newspaper articles	Through friends/relatives
	Posters/Internet	Banners/Brochures
	Others (please specify) :