Registration and Preference Form - Little St Margarets

Little St Margaret's

Kindergarten Application Form
Deferral Form

Yes
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
Please provide a copy of your child's birth certificate

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Please provide a copy of your child's immunisation record*

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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
Is the family a single parent family?*

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Parent / Guardian 2 Address*

Same as parent / guardian 1Different to parent / guardian 1
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 would you like your child to commence at Little St Margaret's?*
What program type is this application relevant to? *
Note: for 3 Year Old Kindergarten, children must be 3 yrs old by commencement of Term 1

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Do you have children that have previously attended this Kindergarten?*

YesNo
Please provide name and year of attendance*
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?*

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
Supporting documentation will need to be sighted on commencement at Sample 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: www.education.vic.gov.au/childhood/parents/support/Pages/financialassist.aspx
Children with Additional Needs
Does your child have any additional 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:
Waitlist Fee

A non refundable application fee is payable for all applications.

How did you hear about us?*

InstagramFacebookWalk-byThrough a friendGoogleSchool newsletterOther
Would you like to pause the send of a notification email for this change?*
Payment Name
Amount
Payment Type
Payment Reference Number
Already Paid?

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

Little St Margaret's

Enrolment & Immunisations

Kinder Fee Subsidy

Children with Additional Needs

Waitlist Fee