application – Memorial Park Kindy

Waiting List Application for Kindergarten

PLEASE COMPLETE THIS ONLINE FORM $20 non-refundable fee is required with your application, upon submitting this form, a notice will appear with the Direct Deposit details. We begin our enrolment process in term 3 the year prior to your child’s attendance, you will receive written correspondence from us at this time. If you change your address at any time, please contact the centre. Please ‘like’ us on Facebook to see up to date information about our centre.

Child's Details

First name *
Second name
Last name *
Gender *
Date of Birth *
Kindergarten Year of Attendance
(Your child must be 4 years of age by June 30) Further information if required is available from the service. Fee information relative to program delivery is available on our website also.
Address *

Number,Street,Town/Suburb,Postcode
Postal: *

Number,Street,Town/Suburb,Postcode

Parent/Guardian Details

Parent Name #1

First

Last
Address

If different from above
Home Ph:
Work Ph:
Mobile Ph: *
Email *
Parent Name #2

First

Last
Address

If different from above
Home Ph:
Work Ph:
Mobile Ph:
Email

Does your child have any additional needs?
Detail of additional needs

Please provide details of anything you think your child may require extra support with e.g. Diet, Sleep, Toileting, Behaviour, Play, Fears, Language

During their kindergarten year will your child also attend another early childhood program?
Other program? *

Yes No
If yes, please indicate

Kindergarten Child Care Centre Family Day Care Other
Details of other if selected
If your child gains a placement in our kindergarten program, will you acknowledge this as your only access to a minimum of 15 hours of an Approved Kindergarten Program?
Will you acknowledge? *

Yes No (Priority of offer of placement may be given to those families who acknowledge this service as their provider of an Approved kindergarten Program for 15hrs due to funding eligibility. Please refer to Access and Admissions policy).