Place of Birth. Nationality: .................................................................................................... Passport number: ......................................................................................... Designated study track: …………………………………................................. agree on this contract under the following terms and conditions: General conditions:
Place of Birth. We support the concept of individualized care based on the unique circumstances and needs of the birthing woman and her family. The College of Midwives of Ontario requires midwives to be trained to attend home and hospital births and to provide clients with these options. Research has shown that, for healthy women enjoying a low risk pregnancy and receiving regular prenatal care, home birth is a safe and reasonable option. The choice of place of birth is a personal decision and many factors must be considered including: risk factors involving mother and/or baby, available facilities, distance from hospital and the environment in which the mother feels most secure. We believe that it is the parents' right to make an informed choice regarding birth setting, understanding that there are risks and benefits to both home and hospital births. Birth is a natural, normal process, but complications and emergencies can arise that require medical intervention. While the majority of complications can be detected prenatally, some may arise unexpectedly during labour and delivery or after the birth. Midwives carry resuscitation equipment, oxygen and medications to treat postpartum bleeding and are trained in emergency skills. Some complications can be handled safely and effectively in the home environment with a skilled midwife in attendance, while others may require transport to a hospital. The willingness to transfer to hospital when there are signs of complications is one of the things that makes home birth a safe option. LABOUR AND BIRTH We see our role as being part of a team, working together with the parents, family and friends (if present), to serve the birthing woman and her baby. Because giving birth is an extension of a woman's whole life, the ways in which a woman experiences labour and birth are many and varied. We are committed to respecting the individual values and needs of birthing families. Much of our work involves quiet observation, reassurance and labour support. Many women desire and achieve unmedicated childbirth. We will remain with you once active labour is established and the condition of mother and baby will be monitored and assessed. The second midwife will come when the birth is imminent. POST-PARTUM If there are no complications or interventions, a woman delivering in the hospital may go home two to three hours after birth. When a baby is born at home, we remain with the mother and baby until both are stable and secure. The minimum time we r...
Place of Birth. Italy Xxxxx, Xxxxxx Xxxxxxx Saved 0, Xxxxx Xxxxxx, Xxxxxx, Southampton Age: 24 Place of Birth: London click here for more information: xxxx://xxx.xxxxxxxx.xxx/images/Xxxxx%2C%20ernest_tcm4-318838.pdf Xxxxx, Xxxxxxxxx Xxxx Xxxxxxx Lost 0, Xxxxx Xxxxxx, Xxxxxx, Southampton Age: 17 Place of Birth: Bedford click here for more information: xxxx://xxx.xxxxxxxx.xxx/images/Xxxxx%2C%20ernest_tcm4-318838.pdf Xxxxx, Xxxxxx Xxxxxxxx Lost 00, Xxxxx Xxxxxx, Xxxxxx, Southampton Age: 26 Place of Birth: London Xxxxx, Xxxxx Xxxxxxx Lost 0, Xxxxxxx Xxxxx, French Street, Southampton Age: 32 Place of Birth: Hants Crew Agreement has 0 Xxxxxx Xxxxxx. click here for more information: xxxx://xxx.xxxxxxxx.xxx/images/Xxxxx%2C%20henry_tcm4-318839.pdf Xxxxxx, Xxxxxx Xxxxxx 2nd Electrician Lost 000, Xxxxxxxxxx Xxxx, Xxxxxxx, Xxxxxxxxxxx Age: 34 Place of Birth: Manchester Xxxxxx, Xxxxx Xxxxxxx Xxxxxxx Lost 73, Obelisk Road, Xxxxxxxx, Southampton Age: 43 Place of Birth: Devon Crew Agreement has age 41. Xxxxxxxx, Xxxxx Able Xxxxxx Saved 0, Xxxxxx Xxxxx, Southampton Age: 40 Place of Birth: Newcastle on Tyne Xxxxxxxx, Xxxxxx X Bedroom Lost 00, Xxxxx'x Xxxx Xxxxxxx, Southampton Age: 48 Place of Birth: Glasgow Xxxxxxx, Xxxxxxxxx Xxxxxxx Delivery voyage only Age: 38 Place of Birth: Belfast Xxxxxxx, Xxxxxxx Xxxxxx Xxxxxxx Saved 000, Xxxxxxxxx Xxxx , Xxxxxxxxxx, Xxxxxxxxxxx (signed on at this address) and 000 , Xxxxxxxxx Xxxx, Xxxxxxxxxx, Xxxxxxxxxxx (XX Senate Hearings) Age: 19 Place of Birth: Liverpool Xxxxxxx, Xxxxxx Xxxxxxxxxxx Lost Windsor Avenue, Belfast Age: 39 Place of Birth: Comber, NI Xxxxxxx & Xxxxx guarantee group Xxxxxx, Xxxxxx Xxxxxx Able Xxxxxx Saved 00, Xxxxxxxxxx Xxxx, Xxxxxxxx, Xxxxxxxxxxx Age: 36 Place of Birth: Hants, Whitenap, Romsey Xxxxxxxxx, Xxxxx Xxxxxxx Delivery voyage only Age: 31 Place of Birth: Belfast Xxxxxxxx, Xxxxxx Xxxxxxxx Clerk Lost 00, Xxxxxxxxxx Xxxx, Xxxxxxxx, Xxxxxxxx Age: 26 Place of Birth: Liverpool Xxxx, Xxxxx Xxxxxxxxx Glory Hole Xxxxxxx Lost 00, Xxxxxxxxx Xxxx, Xxxxxxx, Xxxxxxxxx Age: 32 Place of Birth: Liverpool Xxxxxxxx, Xxxxxxx Xxxxxxxx Lost 00, Xx Xxxxx Xxxx, Xxxxxx, XX Age: 27 Place of Birth: Belgium Xxxx, Xxxxx Xxxxxxx Delivery voyage only Age: 32 Place of Birth: Belfast Xxxxx, Xxxxx Xxxxx Trimmer Saved 000, Xxxx Xxxx, Xxxxxxxxxxx Age: 22 Place of Birth: Hants, Southampton Crew Agreement has Hills Road Xxxxxx, Xxxxx Xxxxxx Assistant Vegetable Cook Lost 00, Xxxxxx Xxxxxx, Xxxxxx, Xxxxxxxxxxx Age: 23 Place of Birth: Hants, Southampton click here fo...
Place of Birth. Education: Primary Middle School Secondary School College Other PERSONAL IDENTITY INFORMATION Type of ID National ID Residency ID Passport Family register Other: .................... ID No.: Place of Issue: Expiry Date ..../..../. H ..../..../. CE NATIONAL ADDRESS AND CONTACT INFORMATION Xxxxxxxx Xxxxxxx Xxxxxxx0: Xxxxxxxx Xx. Xxxxxx Name District Name of the City Post Code Additional Number Mobile phone3: Landline Number4:
Place of Birth. City County State
Place of Birth. With whom does the child live? If stepparent, please give name(s) FATHER’S NAME Name of Employer City Occupation Work Phone ext. Cell Phone Email MOTHER’S NAME Name of Employer City Occupation Work Phone ext. Cell Phone Email Church Membership of Parents _ Attend worship services regularly? Y N Child Baptized? Y N Date of Baptism: Month Year Where How did you learn about Little Palms School? BROTHERS/SISTERS DATE OF BIRTH ❖ Please Place an “X” For Desired Program and Payment Plan. ❖ Circle the days for the desired PS or PK Program PROGRAMS Preschool and Pre Kindergarten - August 3, 2021 – May 12, 2022 Annual Tuition Monthly Tuition Program PSAM 2-Day choose 2 days M T W T F 8:30 – 11:45 a.m. $ 1,500.00 $ 150.00 Program PSAM 3-Day choose 3 days M T W T F 8:30 – 11:45 a.m. $ 2,100.00 $ 210.00 Program PSAM 4-Day choose 4 days M T W T F 8:30 – 11:45 a.m. $ 2,500.00 $ 250.00 Program PSAM 5-Day Monday - Friday 8:30 – 11:45 a.m. $ 3,050.00 $ 305.00 Program PK 2-Day choose 2 days M T W T F 8:30 – 11:45 a.m. $ 1,500.00 $ 150.00 Program PK 3-Day choose 3 days M T W T F 8:30 – 11:45 a.m. $ 2,100.00 $ 210.00 Program PK 4-Day choose 4 days M T W T F 8:30 – 11:45 a.m. $ 2,500.00 $ 250.00 Program PK 5-Day Monday - Friday 8:30 – 11:45 a.m. $ 3,050.00 $ 305.00 Program ESAM Extended School Program A.M. 8:00 – 8:30 a.m. AM & PM - $ 6.00 per hour Program ESPM Extended School Program P.M. 11:45 a.m. – 3:45 p.m. (Billed on the ¼ hour) ❖ 5% discount for early enrollment – completed enrollment & fees received by May 1, 2021 ❖ ❖ 5% discount on second child tuition (lesser amount). ❖ 5% discount will be given if full payment of the annual tuition is made at registration. ❖ 10% discount on tuition for HOSANNA Lutheran Church members ❖ 25% discount to children of Military ❖ 50% discount to children of clergy (second child discount does not apply) ❖ Only one discount will be applied. The largest discount will be applied with the exception of multiple children.
Place of Birth. Place of birth Số (No.):.................................................................. Số (No.):......................................................................... CMND/Thẻ căn cước công dân/Hộ chiếu (*) ID card/ Civil identification card/ Passport Nơi cấp: ............................................................... Place of issue Ngày cấp: ………/………/……… Date of issue Ngày hết hạn:……/……/……… Nơi cấp: ...................................................................... Place of issue Ngày cấp: ………/………/……… Date of issue Ngày hết hạn:……/……/……… (Date of expire): (Date of expire): Mã số thuế (Tax code) …………………………………………………………... …………………………………………………………... Quốc tịch (*) Nationality Việt Nam (Vietnamese) Hoa kỳ (*) (America) Khác (Other) …………………………………. Việt Nam (Vietnamese) Hoa kỳ (*) (America) Khác (Other) ……………………………………….. Dân tộc (*) (Ethnic group) ……………………………………… ……………………………………… MB02D/RB-TKTT/2017 Trang 1/16 Đa quốc tịch (*) Multi-nationality Có Không Không quốc tịch Yes No No Nationality Có Không Không quốc tịch Yes No No Nationality Thị thực nhập cảnh (Trường hợp cá nhân người nước ngoài) Immigration visa (For the case of foreigner) Số (No.):.................................................................. Nơi cấp: ............................................................... Place of issue Ngày cấp: ………/………/……… Date of issue Ngày hết hạn: ………/………/………. Date of expire Số (No.):......................................................................... Nơi cấp: ...................................................................... Place of issue Ngày cấp: ………/………/……… Date of issue Ngày hết hạn: ………/………/………. Date of expire Tình trạng cư trú (*) Residence status Cư trú (Residence) Không cư trú (No residence) Thời gian còn cư trú tại Việt Nam (Remaining residence time in Vietnam) ……………………………………… Cư trú (Residence) Không cư trú (No residence) Thời gian còn cư trú tại Việt Nam (Remaining residence time in Vietnam) ……………………………………… Tình trạng hôn nhân(*) Marriage status Độc thân (Single) Kết hôn (Marriage) Ly hôn (Divorce) Khác(Other)…………………………………... Độc thân (Single) Kết hôn (Marriage) Ly hôn (Divorce) Khác(Other)…………………………………... Địa chỉ thường trú (*) Permanent residence ……………………………………… ……………………………………… ………………………………………… ……..…………………………………… Địa chỉ liên lạc (*) Contact ……………………………………… ……………………………………… ………………………………………… …………………………………………. Điện thoại liên lạc Telephone Di động (*) (Mobile):......................................... Nhà (...
Place of Birth. (City & State or Foreign Country) If applicable, Name and Address of participating lender or surety co.
Place of Birth. Date of Birth:......................................Marital Status:................................... Residential Address (Not P.O. Box):................................................................ ..................................................................................................................... ..................................................................................................................... Preferred mailing Address:.............................................................................
Place of Birth. NATIONALITY: ……………………………………… GENDER: MALE / FEMALE (circle one) IDENTITY PROOF: PASSPORT OR DRIVERS LICENCES #: ……………………………………………………. (Please attach a copy of the same) NEXT OF KIN: (NAME): ………………………………………………………………………………………………………. CONTACT #: …………………………………… RELATIONSHIP TO APLLICANT: ………………………………..
