Deep Creek - Kindergarten Application Form

Deep Creek Preschool Association Inc.

Kindergarten Application Form
Deferral Form

Yes
If you would like to place your child on the waitlist at Deep Creek Preschool please complete the following form.

Please note to qualify for the 3 year old program, your child must turn three years old by April 30th in the year of attendance. To qualify for the 4 year old program, your child must turn four years old by April 30th in the year of attendance.

This enrolment application form requires you to:
- Pay a non refundable application fee payment of $30.00.
- Attach a copy of your child’s birth certificate
- Attach a copy of your child’s immunisation status (formal statement from Medicare)
Please note you will need to complete a separate application form for each child.
Child's Name*

First NameLast Name
Preferred Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
Please upload a copy of your child's birth certificate or suitable evidence of the child's birth date e.g. passport.*

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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
Would you like to add a second parent / guardian?*

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:
Do you have children that have previously attended Deep Creek Preschool?*

YesNo
Child/Sibling Name*
eg. Billie Smith
Year*
Child/Sibling Name
eg. Billie Smith
Year
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
Please upload a copy of your immunisation statement*

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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 CardRefugee visa (subclass 200)In-country Special Humanitarian visa (subclass 201)Global Special Humanitarian visa (subclass 202)Temporary Humanitarian Concern visa (subclass 786)Protection visa (subclass 866)Emergency Rescue visa (subclass 203)Woman at risk visa (subclass 204)Bridging visa A-E for humanitarian or refugee visaHumanitarian Stay visa (subclass 449)Temporary Protection visa (subclass 785)Safe Haven Enterprise visa (subclass 790)Department of Veterans Affairs (DVA) Gold Card or White CardTriplets or QuadrupletsAboriginal or Torres Strait Islander
Supporting documentation will need to be sighted on commencement at Deep Creek Preschool.

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
Is this child or family known to child protection?*

YesNo
Children with Special 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:*
Kindergarten Preferences
What year would you like your child to commence at Deep Creek Preschool?*
What program type is this application relevant to?*
Preference One*
Waitlist Fee

A non refundable waitlist fee of $30 is payable for all applications.

Please Note: This Application Form does not guarantee a confirmed place at Deep Creek Preschool. Confirmation of a place is offered in April/May of the year prior to commencement. Please refer to Enrolments & Orientation Policy (see Attachment 2 – Enrolment general procedures for further information)
How did you hear about Deep Creek Preschool?*

Google SearchRecomendation from a relative/friendMaternal Health Nurse / CentreDeep Creek websiteDrove walked past the preschoolPreschool TourPreschool Open DayAdvertising Material eg. flyers/billboardManningham Directory for Preschools
Why did you apply to Deep Creek Preschool? (please choose 3)

Proximity to home / workDays and times the program is availablePreschool offers a long day (1 day per week)Siblings attend / previously attendedReputation of Service & StaffSessional Standalone preschoolVisited Maternal Health Nurse next doorFees / CostLinks to a particular culture / community groupsService Rating against the National Quality Service
Already Paid?

Yes
child Address*

Street Address

Street Address Line 2

CityState

Post Code
Payment Name
Amount
Payment Type
Payment Reference Number
Should be Empty:

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

Deep Creek Preschool Association Inc.

Enrolment & Immunisations

Kinder Fee Subsidy

Children with Special Needs

Kindergarten Preferences

Waitlist Fee