Noke' Childcare

Noke' Childcare

~ Compatibility & Comfortability ~
Adults name (Please include: pronoun, relationship, phonetic pronunciation, as applicable)
Child's name (Please include: age, pronoun, relationship, phonetic pronunciation, as applicable)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
I would like to be contacted by email or phone (if phone- what time works best?)
I would like my child to begin date , at the age ofyears/months
I would like my child to attend
Do you care for older children attending a nearby school? Where do they attend school? school name
Is your family comfortable around animals?

Other
Are there nut allergies in your household or other severe food allergies?

Other
Do the opening hours of 8am-4:30pm work for your family?

Other

How comfortable is your family with:

Rows	Very	Somewhat	Not at all	Short comments
Outside Time
Mud/ Paint/ Mess
Outings (library, playground, grocery store, etc)
City bus
Long walks/ uneven terrain
English/ Sign language
Child feeding themselves
Stroller/Outside Naps
Playgroups
Encouraging independence

Any thing you would like to add or questions you may have that are not answered at www.nokechildcare.com
Should be Empty: