Waiting List Application

By filling in this form your child's name will be placed on the Waiting List. If you are not offered a place during the year you may wish to contact the Centre to find out the progress of your child's name on the list. Should any details on this form change, please inform the Centre.

If your child is not yet born, please contact the Centre after the birth to add your child’s name and date of birth.

Unfortunately, we cannot guarantee that a place will become available.
Enquiries: Please contact 9693 2243

Child's Name:
Date of Birth:
Baby's due date:
Address:
Home Phone: *
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Gender:
Parent 1 Name: *
Workplace:
Occupation:
Work: *
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Mobile: *
Email: *
Parent 2 Name:
Workplace:
Occupation:
Work:
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Mobile:
Email:
Start Date Required:
Days Required:
Hours Required:
Are these days flexible?
So that the Centre is able to follow the priority of access determined by Family and Community Services,
please indicate any of the following which may apply to you, your child or your family.
Language/s spoken at home?
Does your child have any allergies, special needs or disabilities?