2. Hoeveel kilometer is u huis vanaf Citrusdal? How far (in km) is your house from Citrusdal? *
Your answer
3. In watter graad/grade is die kind(ers) wat u vir koshuisplasing oorweeg? | In which grade(s) are your chidren whom you consider to put in a hostel? *
Your answer
4. Indien u u kind in ons koshuis plaas, wat sal die eerste jaar van plasing wees? | If you put your child in our hostel; which will be your first year of placement? *
Required
5. Verskaf asseblief u naam en van vir opvolgdoeleindes. | Please provide your name and surname for follow-up.
Your answer
6. Verskaf asseblief u selfoonnommer. | Please provide your cell phone number. *
Your answer
Baie dankie vir u hulp. Stuur gerus ook hierdie vorm aan familielede of vriende wat baat hierby kan vind. | Thank you for your assistance. Kindly forward this form to family members or friends who may benefit from it.