[Front side]••• Checklist of documents to be submitted and precautions •••Please check the documents to be submitted and notes at the time of application, and submit thechecklist together.
Submission destination: Children and Family Affairs Division of the ward where the first choicegarden is located

1 Application documents, etc.(required for all)* Education / childcare benefit certification application and facility (business) use application*Facility(business) use application supplementary form *Consent form regarding facility (business) use * My
number(individual number) Declaration Form *My Number (Individual Number) A copy of the personal
number confirmation documents and identity verification documents stated in the declaration form.
2 Documents certifying that childcare is required (for parents and all household members aged 18 to 65)
Grandsituation

WorkingDocuments to be submitted (Please submit both ( 1 ) and ( 2 ) ) Father Mother father

Those who work
for a company
Those who havea job offer
Those who return to work duringchildcare leave or after childbirthSelf-employed /managers

Pregnancy / childbirthdiseasehindrance
Relative care / nursing

Employment certificate(A shift table is attached forirregular work)* The expiration date of theemployment certificate is 3 months
from the date of certification.
(1)

Employment certificate
Copy of business permit, start-up notice,etc. or copy of tax return of previous year

Copy of mother-child notebook of the child
who is planning to give birth (1) Cover (2) Page
showing the expected date of delivery
Medical certificate (disease name, treatment
period, There is a statement that childcare isdifficult)Grand Others
livingmother together

XXXXXXX

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

A copy of the disability certificate
A page that shows the name, disability name, anddisability grade(1) Medical certificate for those who receive longterm care / nursing (2) Long-term care / nursing
schedule that shows the working hours (self-made)

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Job hunting(including entrepreneurial preparation)

Written consent

X

X

X

X

X

Student / vocational training

A copy of your student ID card or student ID card
Timetable (you can make your own)

XXX

X

X

X

X

X

X

X

Disaster recovery

Disaster certificate.

3 Other documents that need to be submitted depending on the situation of the household
Household status

Documents Required(Please submit both 1&2

Children or people with the same
livelihood have disabilities(1)Ownership report of disability
certificate, etc. related to reductionof childcare fees, etc(2)A copy of the disability
certificate, etc.

When a guardian works (does) (1)Pledge for employment ofas a childcare worker at achildcare workers(2)Copy of childcare worker
facility in the city
qualifications, etc.
If you are planning to move infrom outside Chiba City
Divorced andunmarried(1)Pledge regarding moving in(2)Documents that identify thenew address(1) A copy of the Child Rearing
Allowance
Certificate of the certificates of all matters related to thefamily register (with a description of divorce or unmarried)

Father Mother

Father MotherIf using unlicensed
childcare facilities,etc.

Unlicensed childcare facilities, babysitters, etc.
・ A copy of the contract
・ A copy of the receipt
One of them(The usage time per month can be confirmed)X

If you apply for aprenatal child①Oath regarding application for use of nursery school before birth
Contract and consent② A copy of the Mother and Child Handbook(Cover and page showing the expected date of delivery)

X

X

When applying Nursery
centers other thanChiba City

Application time and documents differ depending on the municipality
Therefore, please go to the Children and Family Affairs
Division of your ward to comfirm.

XX

If parents are working Pledge paper regarding employment
as city room instructors as an instructor such as a child roomXXX

Single-parent
During divorce
householdtrial
Those who arein divorce mediation(1) A petition relating to the residence status of the parents(2) Certification of arbitration or in trial(eg, a copy of the mediation date callletter, a Case pending certificate, etc.

X

Application for children withdisabilities, injuries oroutpatients(1) Statement of opinion(medical certificate) ofthe attending physician(2) Other documents that show the condition of the childX

Documents showing the statusof allergies If you do not have,describe details on a paperX

Pledge to live in a large-scalecondominium
Copy of the contract with nameX

application for a child withallergies, please fill in thedetails on the separate table.
[Mihama Ward only]
If you like to enter thecondominium resident
priority school

Household status Documents (Please submit both (1) & (2)A copy of your passport (page showing
Parents are living overseas immigration)* To confirm the taxable address as ofJanuary 1st.
Reiwa 3rd year
Those who moved to ・Resident tax (non-) taxation certificate
Chiba after January ・Municipal tax / prefectural tax income
1, 3rd year of Reiwa (taxable) certificate
One of them
If you agree to lower the Notification regarding selection orderselection ranking because it change due to extension of childcare leave
was possible to extend
childcare leave

XX

X

X

X

X

X

4 Notice□ The selection result may be disadvantageous depending on the omission of the application form or the missing documents. Please check thedocuments before submitting.
□ There are various differences depending on the kindergarten, such as available hours and whether or not childcare is provided on Saturdays.
Please check when deciding your desired destination.
□ Applications and required documents that have arrived at the Children's and Family Affairs Division by the deadline are valid.
The city will not be held responsible for any omissions in the required documents or non-delivery due to a mailing accident.

Date
Parental signatureChild’s Name

Birth DateYear[Please also check the back side]

MonthDate[Back side]

Precautions / confirmation items related to admission selection / admission to nursery schools /certified children's institutes (Be sure to check the "Documents to be submitted / Precautions checklist" on the front
NoTarget person

1

All Household

2All Household

itemexplanation

Notification time of selection results
for all households (admission in April)

Results will be notified for the first selection in late January and forthe second selection in late February.

Notification date and time ofselection results (admission fromMay to March )Results will be notified at the end of the month before the selection target
month (generally after 20th of the month).

All Household

Handling in case of disapproval

The selection will continue until the end of the fiscal year (admission inMarch). If you no longer need to be selected, please submit a "Notice ofWithdrawal of Application for Use". In addition, the notice of disapproval will
be sent only for the first selection. (If you need a notice of disapproval
other than the first selection month, please contact the Children and Family
Affairs Division.)

4All Household

About the location of the residence
certificate

If you have decided to enter the school as a result of "application foradmission as a citizen of Chiba" or "application for admission on thepremise of moving to Chiba City", the offer will be canceled if the resident
card is not in Chiba City at the end of the month before the fixed monthof admission. ..

5All Household

About childcare feesChildcare fees for children under 3 will be notified after admission is decided.
(Early April for admission in April, late previous month for admission from May toMarch)

3

6All Household

About supplementary food expenses

Childcare fees for children over 3 years old are free, but supplementary meals
will be charged separately.
Since the cost of supplementary food varies depending on the school, pleasecontact each school for details. * Exemption :depending on the household's
municipal tax income percent. Households eligible for exemption will be notified
after the decision to enter the park.

7All Household

Procedures after admission

Procedures are required if the following items are changed in the household after
entering the park
Please contact the Children's and Family Affairs Division of the ward as there may
be cases.
① Change of household member's name, address, living together / separated, etc.
② Change of employment, unemployment, job change, working hours, etc.
③ If you become pregnant

8All Household

Procedures for leaving

If you leave the school before graduation, please contact the Children's Family
Division or the facility you are using by the day you leave the school.
Please submit "Notice of Cancellation of Facility (Business) Use".

9ApplicationD
uring
childcareleave

About the return date when theapplication is made during childcare
leave

You will need to return to work in the month of admission. If the end date ofchildcare leave stated on the employment certificate received at the time ofapplication is other than "the month of admission or the end of the month before
admission", the work certificate (reflecting the latest end date of childcare leave) by
the end of the month before the month of admission. Please resubmit.

10Application
duringchildcareleave

About "Notification of the order ofadmission due to the extension ofchildcare leave

If you submit this notification, the ranking will be lower than those who did not
submit it. It will be possible to select. However, depending on the availability of thegarden, a job offer may be offered.
Please note that it may appear.

11

Application
during job
hunting

Period of use during job hunting

One (or both) of the parents applied while looking for a job, and a job offer for achildcare facility was issued. If so, you can use it for 3 months. To continue using
Is working that can be seen as "working for 64 hours or more per month" during theperiod. You need to have your certificate ready and go to the Children's and Family
Affairs Division.

12

Certified childschool
application

About expenses and closed days ofcertified child school

At the certified children's school, there are expenses unique to the school such as"uniform fee" and "Obon(summer) holiday" and closed days.
It may be set. Please check with each school for details.

13Certified childschool
application

About changes of Education / childcare
benefit certification category afteradmission

To change the education / childcare benefit certification category (No. 1 ⇔ No. 2) after
entering the school. It is required to complete the procedure at the Children's and Family
Affairs Division of the Ward after obtaining the consent of the school in advance.

[Please also check the front side]