Application Form - Geelong West

Thank you for choosing Geelong West kindergarten for the care and education of your child.

Please note, this is an application form only. It is not confirmation of a kindergarten place.

Applications will incur a non-refundable $30 application fee via credit card.

Kindergarten places are allocated to eligible children in accordance with the Department of Education Priority of Access and our Locally Agreed Criteria. See our website for more details.

When to start kindergarten:

Please note that your child cannot start kindergarten until they have had their third birthday.

Three year old kindergarten - Government Funded Program

Children must be three years old to attend Three-Year-Old Kindergarten.

Families with children born between January and April are strongly recommended to consider the best time for their child to access Three-Year-Old kindergarten, as this will impact on their one year of Four-Year-Old kindergarten and their school starting age. e.g. If you access Three-Year-Old Kindergarten in 2026, your child will transition to Four-Year-Old Kindergarten in 2027, then school in 2028.

Four year old kindergarten - Government Funded Program

Children must be four years old by 30 April in the year they are attending kindergarten to be eligible.

Children will only be able to access one year of Government Funded Four-Year-Old Kindergarten and will transition to school the following year, unless your child is assessed as being eligible for a second year of Four-Year-Old Kindergarten (when a child shows delays in at least two key outcomes of learning and development as assessed by your child’s kindergarten teacher).

Child Is	Eligible for 3YO	Eligible for 4YO	Eligible to attend school
Born before 30 April 2023	2026	2027	2028
Born before 30 April 2024	2027	2028	2029
Born before 30 April 2025	2028	2029	2030

YesNo

Acknowledged

What year would you like your child to commence at Geelong West Kindergarten? *

What program type is this application relevant to? *

Yes

Child's Name*

First NameLast Name

MaleFemaleUnspecified

Child's Date of Birth*

Address*

Street Address

Street Address Line 2

CityState

Post Code

Parent / Guardian 1*

First NameLast Name

Relationship to the child*

Same as childDifferent 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

YesNo

Health Care Number*

Health Care Expiry Date*

Please attach a copy of your Health Care card*

Browse Files

YesNo

Pensioner Number*

Pensioner Card Expiry Date*

Please attach a copy of your Pensioner Concession card*

Browse Files

YesNo

Department of Veterans Affairs Number*

Department of Veterans Affairs Expiry Date*

Please attach a copy of your Department of Veterans Affairs card*

Browse Files

YesNo

Please provide further details*

0/230

Please attach a copy of the assessment or letter*

Browse Files

YesNo

Parent / Guardian 2*

First NameLast Name

Relationship to the child*

Same as childDifferent 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

YesNo

Health Care Number*

Health Care Expiry Date*

Please attach a copy of your Health Care card*

Browse Files

YesNo

Pensioner Number*

Pensioner Card Expiry Date*

Please attach a copy of your Pensioner Concession card*

Browse Files

YesNo

Department of Veterans Affairs Number*

Department of Veterans Affairs Expiry Date*

Please attach a copy of your Department of Veterans Affairs card*

Browse Files

YesNo

Please provide further details*

0/230

Please attach a copy of the assessment or letter*

Browse Files

By completing the following information, you will help our team support your family. This information will also be used to access priority of access for a kindergarten placement and access to additional hours for priority cohorts (as defined by the Department of Education)

NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander

YesNo

Health Care Number*

Health Care expiry date*

Please attach a copy of your Health Care card*

Browse Files

YesNo

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found here.

Second Year of Funded Kindergarten

Children enrolled in a funded kindergarten program are eligible to access a repeat year of funded 3 or 4 year old kindergarten, only if the early childhood teacher has assessed eligibility for your child to be considered for a second year.

YesNo

Which service did they previously attend?

By completing the following information, you will help our team support your family. This information will also be used to access priority of access for a kindergarten placement and access to additional hours for priority cohorts (as defined by the Department of Education)

YesNo

Child eligible or undergoing assessment for a disability under the NDISChild eligible for Early Childhood Intervention Service Continuity of SupportChild diagnosed with a disability or developmental delay or undergoing diagnosisChild with developmental concerns that presents barriers to accessing a kindergarten programChild has complex medical needs that presents barriers to accessing a kindergarten programChild holds Disability Health Care CardChild previously accessed Kindergarten or Commonwealth Inclusion Support or similar programReferred by NDIS or Early Childhood Intervention or Preschool Field Officer or MCH nurse or similar

YesNo

Name of support service / agency*

max 255 characters

YesNo

If yes, please select one of the following:*

Please attach a copy of relevant documentation

Browse Files

Max 10MB total file size

YesNo

Please attach a copy of relevant documentation

Browse Files

Max 10MB total file size

YesNo

Names of your other children that have attended Geelong West Kindergarten

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

YesNo

Geelong West Kindergarten Application Fee$30.00AUD

Total $0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Yes

Payment Name

Amount

Payment Type

Payment Reference Number

Form Name

Geelong West Kindergarten Application Form

Additional information about your child

Prior Connection

Enrolment & Immunisations

Application Fee