ITEM RESPONSE
CHILD/DEPENDANT THREE
Complete Name
Relationship to Member
Parent / Guardian Name and Contact
Information
Parent / Guardian Name and Contact
Information
Name and Contact Information
of Child Care Provider
Date of Birth
Health Card Number
Special Needs
Allergies
Health/Medical Conditions
(Refer to Medical Section of Binder)
YOU SHOULD KNOW…
ITEM RESPONSE
CHILD/DEPENDANT TWO
Complete Name
Relationship to Member
Parent Name and Contact Information
Parent Name and Contact Information
Name and Contact Information
of Child Care Provider
Date of Birth
Health Card Number
Special Needs
Allergies
Health/Medical Conditions
(Refer to Medical Section of Binder)
YOU SHOULD KNOW…
There are two types of birth certificates; the short form and the long form. The short form is the common wallet-sized card that you are most
likely familiar with, but in some cases you may need the long-form version. For example, if you would like to submit an application for a
passport for one of your children, you must provide the long form version, because it contains the names of both parents. Make sure to have a
copy of both the short and long form documents (if applicable depending on age of child).
