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
Child's Name

First nameLast name
Gender
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
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?
Names of your other children that have attended Helen Paul Kindergarten:
About Helen Paul Kindergarten
How did you hear about Helen Paul Kindergarten (HPK)?
How did you hear about Helen Paul Kindergarten (HPK)?
Why did you choose Helen Paul Kindergarten? Please select all options that apply.
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?
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 Card Number
Health Care Expiry Date

DayMonthYear
Pension Number
Pension Card Expiry Date

DayMonthYear
Please provide a copy of your concession

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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
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:
Additional Health and Medical Information
Has your child ever been diagnosed as at risk of anaphylaxis?
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

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Does your child have any allergies?
Please provide details (allergies and treatment)

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

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Does your child have asthma?
Please provide details (including any medication requirements)

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

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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
Please provide details

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

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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
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?
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