St Augustine's Kindergarten Application Form - Standalone Kinder (with deferral)

Pre-school Program Application Form

St Augustine's Kindergarten
Internal Application Form

St Augustine's Kindergarten
Child's Name

First NameLast Name
Gender
Child's Date of Birth

DayMonthYear
Address

Street Address

Street Address Line 2

CityState

Post Code
Parent / Guardian 1

First NameLast Name
Relationship to the child
Address
Address

Street Address

Street Address Line 2

CityState

Post Code
Phone Number
Email
Please Note: You will be notified of all correspondence via email
Would you like to add a second parent / guardian?
Parent / Guardian 2

First NameLast Name
Relationship to the child
Address
Address

Street Address

Street Address Line 2

CityState

Post Code
Phone Number
Email
Please Note: You will be notified of all correspondence via email
Language/s spoken at home:
Service Preference
What year would you like your child to commence?
What program type is this application relevant to?
Is or has this child been known to Child Protection (with DFFH services)?
Does this child live in Out-of-Home Care (OoHC)
Map OoHC
Do you have children that have previously attended St Augustine's Kindergarten?
Names of your other children that have attended St Augustine's Kindergarten
Does this child have a sibling who has previously attended this Kindergarten?
Enrolment & Immunisations
The Government’s No Jab No Play laws require all children to be age-appropriately immunised before enrolment can be confirmed. Further information on immunisation requirements for enrolment in early childhood services is available on the State Government's Better Health Channel at www.betterhealth.vic.gov.au/campaigns/no-jab-no-play
Are your child's immunisation up to date?
Kinder Fee Subsidy
Please indicate if you are eligible for one of the following concessions, or meet one of the following criteria:
Health Care card number
Health care card expiry date

DayMonthYear
Date
Pensioner card number
Pensioner card expiry date

DayMonthYear
Date
Supporting documentation will need to be sighted on commencement at St Augustine's Kindergarten by the Enrolments Officer.

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found at: https://www.vic.gov.au/free-kinder
Children with Additional Needs
Does your child have any additional needs
If yes, please specify:
You are encouraged to discuss your child's needs with the educator when your child's place is confirmed.
Is your child registered with a specific Support service / agency?
Name of support service / agency:
Acknowledgment
Waitlist Fee
A non refundable waitlist fee is payable for all applications. Should you be unable to pay, please contact the Enrolment Officer at: st.augustines.anglican.kin@kindergarten.vic.gov.au to arrange an alternate payment method.

Please confirm your child's application at St Augustine's Kindergarten by paying the $25 waitlist fee via direct funds transfer (details below) and then submitting this form.
BSB: 063109

Account Number: 00921907

Account Name: St Augustines Kindergarten

Payee Description: Child’s name
EFT Reference
Date Paid

DayMonthYear
Date
Already Paid?
internal_hide
show_suppress_notification
Payment Name
Amount
Payment Type
Payment Reference Number
Form Name
Supress Notifications
Do you work or live in the City of Whitehorse?
Should be Empty:

Pre-school Program Application Form

Internal Application Form

Enrolment & Immunisations

Kinder Fee Subsidy

Children with Additional Needs

Acknowledgment

Waitlist Fee