Application (Registration) Form - Helen Paul Kindergarten

Helen Paul Kindergarten Finalisation of Offer Form
Welcome and thank you for choosing Helen Paul Kindergarten (HPK). We're so pleased to welcome you to our community and to our current families, we're thrilled to have you back!

Please complete the following form in order to confirm your child's place at Helen Paul Kindergarten (HPK) in 2021. This form must be completed within seven days of receiving your offer via Bayside City Council, or your child's place in our kindergarten program may be forfeited. This form is required to be completed in one sitting.

Please feel free to contact me should you have any questions regarding the completion of this form, or the enrolment process.

Thank you. We look forward to welcoming you and your child to our kindergarten community.

Anna Smith
Operations Manager, Helen Paul Kindergarten
(03) 9598 6416 | info@hpk.org.au
www.helenpaulkindergarten.org.au
33 Kingston Street, Hampton, VIC 3188
Deferral Form

Yes
Child's Name*

First nameLast name
Gender*

MaleFemaleUnspecified
Child's date of birth*

DayMonthYear
Parent / Guardian 1*

First nameLast name
Relationship to the child*
Address*

Street address

Street Address Line 2

CityState

Post code
Phone Number*
Email*
Please note: you will be notified of all correspondence via email. This email will be used for all future correspondence unless otherwise advised.
Parent / guardian 2

First nameLast name
Relationship to the child
Address

Same as Parent / guardian 1Different 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:
What year does this registration apply for?*
What year are you registering your child for
What program type is this application relevant to? *
Do you have children that have previously attended Helen Paul Kindergarten?*

YesNo
Names of your other children that have attended Helen Paul Kindergarten:
About Helen Paul Kindergarten
How did you hear about Helen Paul Kindergarten (HPK)?*

Word of mouth (from a friend or family member)A poster in the Hampton CommunityBayside City CouncilSibling attended HPKWebsite or Online SearchOther - please specify
How did you hear about Helen Paul Kindergarten (HPK)?
Why did you choose Helen Paul Kindergarten? Please select all options that apply.

To become more involved in my local communityThe bush kinder program for the 4YO groupsThe location/distance from home or workThe reputation of the kindergartenThe days and times suited my family's needsHPK's rating against the National Quality StandardsCostMy other child / children attended Helen Paul KindergartenChildren are likely to go to the same school togetherOther - please specify
Why did you choose Helen Paul?
Are you currently a member of the Helen Paul Kindergarten Committee of Management?
Enrolment & Immunisations
Please note: Your enrolment cannot be confirmed until we have sighted your child's immunisation history statement which shows your child is up to date with immunisations for their age. You will be required to provide a copy of your childs Immunisation History Statement with the upcoming enrolment form.

You can get your immunisation history statement straight away using either:
- your medicare online account via my.gov.au
- Express Plus Medicare mobile app
Are your child's immunisation up to date?*

YesNo
Kinder Fee Subsidy
DET provides a fee subsidy for eligible families. Please indicate if you are eligible for one of the following concessions, or meet one of the following criteria:

Health Care CardPensioner Concession CardDVA Gold CardBridging Visas A – FTemporary Protection/Humanitarian Visas 447, 451, 785 or 786Resolution of Status Visa (RoS) Visa Class CD, Subclass 851Refugee and Special Humanitarian Visas 200–217Triplets or QuadrupletsAboriginal or Torres Strait Islander
Health Care Card Number*
Health Care Expiry Date*

DayMonthYear
Pension Number*
Pension Card Expiry Date*

DayMonthYear
Please provide a copy of your concession*

Browse Files

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Supporting documentation will need to be sighted on commencement at Helen Paul Kindergarten.

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found at: www.education.vic.gov.au/childhood/parents/support/Pages/financialassist.aspx
Children with Special Needs
Does your child have any special needs*

YesNo
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?*

YesNo
Name of support service / agency:
Additional Health and Medical Information
Has your child ever been diagnosed as at risk of anaphylaxis?*

YesNo
Please provide details (including if your child has as auto injection device eg. epipen)*

0/255
If you have a medical action plan please attach it here

Browse Files

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Does your child have any allergies?*

YesNo
Please provide details (allergies and treatment)*

0/255
If you have a medical action plan please attach it here

Browse Files

Cancelof
Does your child have asthma?*

YesNo
Please provide details (including any medication requirements)*

0/255
If you have a medical action plan please attach it here

Browse Files

Cancelof
Does your child have any specific healthcare needs including any medical conditions that are relevant to the care and education of the child? e.g, epilepsy, diabetes etc*

YesNo
Please provide details*

0/255
If you have a medical action plan please attach it here

Browse Files

Cancelof
Payment of Finalisation of Offer Fee

At Helen Paul Kindergarten we require a $150 Finalisation of Offer Fee (non-refundable) to secure a place for your child. This consists of a $50 administration fee, and a $100 deposit that will be deducted from your child's Term 1 fees. This payment will also attract a surcharge of $3.10.
Total Payable $
Deposit Reference Name
EFT Deposit Date

DayMonthYear
Already paid

Yes
Following the submission of this Form you will receive an automatic reply email requesting session preferences for your child. Please complete this form as soon as possible.
Is Parent 1 or 2 a committee member?

Committee Member
Payment Name
Amount
Payment Reference Number
Payment_type
Should be Empty:

Helen Paul Kindergarten Finalisation of Offer Form

About Helen Paul Kindergarten

Enrolment & Immunisations

Kinder Fee Subsidy

Children with Special Needs

Additional Health and Medical Information

Payment of Finalisation of Offer Fee