Day Care Registration Form for Modi'in and the Surrounding Areas Only

Pre-school teachers: please fill out the details in this form to be listed on our site.

Day Care Name:		Pre-school Teacher's Name:
Telephone:		Cellular Phone:
Email:	(Optional)	Web Site:	(Optional)
Address:			Neighborhood - Select - Buchman Giva C Kaiser Kfar Rut Lapid Modi'in Malibu Center Re'ut Tzipori Shimshoni
Operating Days:	From: - Select - Sunday Monday Tuesday Wednesday Thursday Friday To: - Select - Sunday Monday Tuesday Wednesday Thursday Friday	Operating Hours:	From: - Select - 07:00 07:30 08:00 08:30 09:00 09:30 10:00 To: - Select - 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00
Operating Hours for Friday:	From: - Select - 07:00 07:30 08:00 08:30 09:00 09:30 10:00 To: - Select - 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00	Number of Children:
Number of Team Members:	- Select - 1 2 3 4 5 6 7 8 9 10	Number of Classes:	- Select - 1 2 3 4 5 6 7 8 9 10
Children's Ages in the Day Care:		Number of Meals Per Day:	- Select - 1 2 3 4 5 6 7 8 9 10
Day Care Affiliation:

Additional Information

Teacher Background:
Day Care Background:
General Activities (clubs, etc.):
Addtional Comments/Remarks:
Special Requests for the "My Modi'in" Web Team::