City Of Kingston Childcare and Education and Four Year Old Kindergarten PLUS Application form

* Denotes the field is mandatory

Child Details

Male Female

Do you speak a language other than English at home ? If yes, please specify.

Do you or your child identify as an Aboriginal or Torres Strait Islander?:

Family Details

 

Parent 1

Male Female

Home Address:

Click here if this parent's address details are the same as the child's address details

Work Phone:

Home Phone:

Mobile Phone:

Single parent: Yes No

Healthcare Card Holder: Yes No

Include 2nd Parent/Guardian details

Parent 2

Male Female

Home Address:

Click here if this parent's address details are the same as the child's address details

Work Phone:

Home Phone:

Mobile Phone:

Education and Care Preferences

  • Please tick one of the following reasons for requiring care:
    Work/Study Social
  • When would you prefer to start education and care?:
  • Please number in order of preference which centre/s you wish to be considered for (at least one must be selected):
  • Carrum Child Care and Education
    Carrum Kindergarten PLUS
    Edithvale Child Care and Education
    Edithvale Kindergarten PLUS
    Parkdale Child Care and Education
    Parkdale Kindergarten PLUS
  • Days you require (please select):
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
  • Can these days be flexible?:
    Yes No
  • What is the number of days you require education and care for?:
  • Minimum number of days you would accept:

Health Information

  • Does your child have any health or medical concerns?
    Yes No

Other Information

  • Does your child have a sibling currently attending a care and education program at one of our Centres?:
    Yes No

  • Does your child have a sibling currently on the waiting list for a care and education program at one of our Centres?
    Yes No

  • Is there anything else you would like to tell us about your child or application?

The Victorian Government's No Jab No Play legislation came into effect on 1 January 2016. This means that to enrol at one of Council's Family and Children's Centres, children must be fully vaccinated for their age.

I understand and acknowledge the above statement and declare the information provided to be true and correct at the time of application.

Information provided for this form will be used for the purpose of allocating vacant child care places at a City of Kingston Child care Service.

Personal information collected by Council is used for municipal purposes as specified in the Local Government Act 1989. The personal information will be held securely and used solely by Council for these purposes and/or directly related purposes. Council may disclose this information to other organisations if required or permitted by legislation The applicant understands that the personal information provided is for the above purpose and that he or she may apply to Council for access to and/or amendment of the information. Requests for access and/or correction should be made to Council’s Privacy Officer. A full copy of our Privacy Policy may be obtained from the Kingston website or from one of our Customer Service Centres.

I have read and understood the information privacy statement outlined above.

Tick this box if you would like to register another child after submitting this application