Waiting List Application


Parent 1

First Name (required)

Last Name (required)

Address (required)

Home Phone (required)

Mobile Phone (required)

Work Phone (required)

Email (required)

Ethnicity (required)

Work/Study Details (required)

Parent 2

First Name

Last Name

Address

Home Phone

Mobile Phone

Work Phone

Email

Ethnicity

Work/Study Details




Child 1

First Name (required)

Date of Birth (required)

Male / Female (required)
 Male Female

Languages spoken (required)

Days Required

2 Days :  Mon & Tue Thur & Fri

3 Days :  Mon, Tue, Wed Wed, Thur, Fri

4 Days :

5 Days :  Mon, Tue, Wed , Thur, Fri

I am flexible with days :  Yes No

Number of days required :

Does your child have any additional needs :
 Yes No
Please specify:

Child 2

First Name

Date of Birth

Male / Female
 Male Female

Languages spoken

Days Required

2 Days :  Mon & Tue Thur & Fri

3 Days :  Mon, Tue, Wed Wed, Thur, Fri

4 Days :

5 Days :  Mon, Tue, Wed , Thur, Fri

I am flexible with days :  Yes No

Number of days required :

Does your child have any additional needs :
 Yes No
Please specify:

Child 3

First Name

Date of Birth

Male / Female
 Male Female

Languages spoken

Days Required

2 Days :  Mon & Tue Thur & Fri

3 Days :  Mon, Tue, Wed Wed, Thur, Fri

4 Days :

5 Days :  Mon, Tue, Wed , Thur, Fri

I am flexible with days :  Yes No

Number of days required :

Does your child have any additional needs :
 Yes No
Please specify:




Additional Information

Hours of Care Required
am until pm

When would you like to commence at the kindergarten?

How did you hear about us?

Do you require translation of centre information in another language other than english?  Yes No
Please specify:

Additional comments



Priority of Access for filling vacant places is as follows

Priority 1: A child at risk of serious abuse or neglect.

Priority 2: A child of a single parent who satisfies, or of parents who both satisfy, the work, training, study test.

Priority 3: Any other child


Thank you! A member of staff will contact you shortly to arrange a tour of our Kindergarten and to confirm your waiting list application.