Make a request (Eng. version) / Doe een aanvraag | Stichting Leergeld Waddinxveen

Salutation m/f *

Ms/mrs
Mr

First name *

Surname *

Address with house number *

Postal code *

Residence *

Waddinxveen
other place of residence *)

*) In case of 'other place of residence' click here and do not complete and send this form further.

E-mailadres *

Telefoonummer *

Do you have a partner? *

yes
no

Net family income per month? *

Are you a client of VluchtelingenWerk (Dutch Council for Refugees)? *

yes
no

What language(s) do you speak? *

How many children under 18 live in your household? *

For which child are you applying: first and last name of the child? *

Date of birth of this child *

Gender of this child *

girl
boy
private

Education (school year 2023-2024) *

Not yet at school
Primary school
Secondary school
Secondary vocational education (MBO)
Practical education
Special primary education
Special secondary education

Name of the school *

What are you requesting for this child? Only ONE item possible! *

Laptop or computer
Bicycle
School trip, excursion or schoolcamp (only primary schools)
Squla (remidial teaching games 6 - 12 years old)
WoordExtra (vocabulary program 3 -6 years old)
Something else:

DEMAND 'JARIGE (BIRTHDAY) JOB' ONLY FOR NEW FAMILIES:

Would you like to register your child(ren) for Jarige Job's birthday box?

yes
no

By sending the application, you indicate your agreement with the Personal Data Privacy Regulations of St Leergeld Waddinxveen. These regulations can be found on this website by pressing this link: Privacy Regulations St. Leergeld Waddinxveen.

Stuur mij een kopie

Before you apply for an allowance from Leergeld Waddinxveen, you must first have used the 'Minimaregelingen' of the Gemeente Waddinxveen. See the 'Schemes and links' button for this.

APPLICATION FORM LEERGELD WADDINXVEEN