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SAK Lörrach e.V.
Dieter-Kaltenbach-Stiftung
Gemeindekindergarten Brombach
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Data of a parent or legal guardian
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First name
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Bitte Ihren Wohnort angeben
Gross household income per month
0 - 1.499 €
1.500 - 2.499 €
2.500 - 3.499 €
3.500 - 5.999 €
mehr als 6.000 €
Employment situation
Singe parent / legal guardian is working
Singe parent / legal guardian is a job-seeker
Both parents / legal guardians are working
Both parents / legal guardians are job-seekers
One parent / legal guardian is working another is a job-seeker
I have at least one additional child in a public kindergarten
Name of the kindergarten
I am a single parent
Further information and contact details
Name of the emergency contact
Telephone number of the emergency contact
Other persons authorised to pick up
I agree that my data and the data of my children will be electronically processed and passed on to the supervising organisation.*
Further information on data protection can be found in the
Privacy policy
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