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.
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

part timefull time
Do you care for older children attending a nearby school? Where do they attend school? school name
Is your family comfortable around animals?

AllNonebugs/ wormsbirdsonly catsonly dogsOther
Are there nut allergies in your household or other severe food allergies?

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

YesNoOther

How comfortable is your family with:

	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: