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Details mother
2
Details of the Family
3
Details for payment
4
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Mother's first name
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Mother's name
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Mother's National Register number
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I do not know the National Register number
Mother's date of birth
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Mother's date of birth: Year
Year
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
Mother's date of birth: Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Mother's date of birth: Day
Day
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2
3
4
5
6
7
8
9
10
11
12
13
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15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Email adress
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I live in
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Flanders
Brussels
Wallonia
not in Belgium
Your postcode
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I want to become a KidsLife customer for my Growth Package and/or Child Benefit payments. I consent to the processing of my personal data as set out in the KidsLife policy.
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You hereby confirm that you wish to become a customer of KidsLife and that we may contact you with relevant information.