Enrol now - Counties Manukau Kindergarten Association

General Information
Requested Centre*
Relation to Child*
Adult Full Name*
Home Phone Number*
Mobile Phone Number
Home Address*
Email*
How did you hear about us?*
- Google or other Search Engine
- CMKA Website
- Parent (Referral)
- Social Media (eg Facebook)
- Print Advertisement (eg Newspaper or Magazine)
- Flyer/ Road Side Signage
Child's Information
Child's Name*
First Last
Child's Gender*
- Male
- Female
Child's Date of Birth*
DD slash MM slash YYYY
Days/ Hours Required

Please type under each day which hours your child requires. For days you do not require please leave blank.
Monday
Tuesday
Wednesday
Thursday
Friday
Other Comments
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General Information