Application Form - Warrandyte Kindergerten

Kindergarten Application Form

Warrandyte Kindergarten
Deferral Form

Yes
Hide for Validation Form

Yes
This registration form can be used to access our Pre-Kinder Play fee-based program and/or place your child on the application waitlist for our 3 year old and 4 yearl old programs:

3 Year Old Applications

Child must be aged three by 30 April in the year of attendance to enrol, but cannot attend until they turn three years of age.

4 Year Old Applications
Child must be aged four by 30 April in year of attendance.

Pre-Kinder Play Applications
Child must be aged three or four in the year of attendance, but cannot attend until they turn at least three years of age.
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
Address*

Street Address

Street Address Line 2

CityState

Post Code
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Address

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

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Address*

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
Language/s spoken at home:
What year would you like your child to commence at Warrandyte Kindergarten? *
What program type is this application relevant to? *
Do you have other children (i.e. siblings) that have previously attended Warrandyte Kindergarten?*

YesNo
Names of your other children that have attended Warrandtye Kindergarten *
Do you live in Warrandyte (3113), North Warrandyte (3113), South Warrandyte (3134) or Park Orchards (3134) district?

YesNo
Does this child have a sibling who has previously attended this Kindergarten?

YesNo
How did you hear about us?

Word of MouthFacebookWebsitePassing ByWarrandyte DiaryOther
Enrolment & Immunisations
Under the ‘No Jab, No Play’ legislation, before enrolling a child, early childhood education and care services have to first obtain evidence that the child is up to date with all vaccinations that are due for their age, or that they are able to receive.

An Immunisation History Statement from the Australian Immunisation Register (AIR) is the only form of documentation accepted for the purpose of enrolling in an early childhood education and care service.

After enrolment, parents will need to continue to provide up to date Immunisation History Statements to their child’s early childhood service, if their status changes.

You can get your immunisation history statement straight away by accessing your medicare online account via my.gov.au

If you can't use Medicare online, we can print your immunisation history statement for you.

You can also call the AIR enquiries line (1800 653 809) and ask them to send your immunisation history statement to you. It can take up to 14 days to arrive in the post.

Please note: Only Immunisation History Statements from the Australian Immunisation Register will be accepted as evidence of immunisation.
Are your child's immunisations up to date?*

YesNo
My child has had all their 4 Year Old Immunisations as per the attached immunisation statement.*

YesNo
What date is your child due for their next immunisation?*

DayMonthYear
Please upload a copy of your child's Immunisation History Statement

Browse Files

Cancelof
Information for bodies which provide funding to this service

From time to time the Regulatory Authorities seek information on the characteristics of the children and their families who use an Education and Care service. This is used in planning new policies, programs, and resources to support services. To help provide accurate information please answer the following questions.
Has this child already accessed a funded kindergarten program?*

3 Year Old4 Year OldNo
Is the child eligible for a second year of funded kindergarten?*

YesNo
Is this child Aboriginal or Torres Strait Islander?*

NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander
The State Government 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:

Commonwealth Health Care CardCommonwealth Pensioner 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 IslanderCurrent or expired ImmiCard
Supporting documentation may need to be sighted on commencement at Warrandyte Kindergarten by the Administration Officer or Teachers.

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found at: https://www.vic.gov.au/costs-kindergarten
Is this child or family known to child protection?*

YesNo
Children with Additional Needs

Children who require any additional support due to a disability including intellectual, sensory or physical impairment?
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:
Declaration
Warrandyte Kindergarten is committed to:
- Responsible and secure collection and handling of personal and health information.
- Protecting the privacy of each individual's personal information.
- Ensuring individuals are fully informed regarding the collection, storage, use, disclosure, and disposal of their personal and health information, and their access to that information.
- Proactively sharing information to promote the wellbeing and/or safety of a child or a group of children, consistent with their best interests.
In submitting an application to a 3 year old or 4 year old program, I give permission for this information to be shared with Warrandyte Kindergarten for the purposes of:**

Placing the child on the application waitlistAccessing funded kindergarten at Warrandyte Kindergarten and, if applicable, applications for State funding necessary to provide additional support for my child’s participation.
Please provide your signature here: First Name* Last Name* Signature*
Application Fee
A non-refundable Administration Fee of $50 is payable upon submission of this form.

Children/families that meet criteria for the Department of Education’s Priority of Access and/or are eligible for a Fee Subsidy are not required to pay the deposit. Please contact our office – warrandyte.kin@kindergarten.vic.gov.au or 0499 197 256

Families experiencing hardship are encouraged to contact our office.
Please make a bank deposit to Warrandyte Kindergarten account and provide EFT reference below.

Amount: $50.00

BSB Number: 633-000

Account Number: 12-111-8061

Reference: child's first and last name
EFT Reference Number*
As referenced on your bank transfer
Payment Date*

DayMonthYear
Date
Already Paid?

Yes
Payment Name
Amount
Payment Type
Payment Reference Number
Form Name
Should be Empty:

Kindergarten Application Form

Enrolment & Immunisations

Information for bodies which provide funding to this service

Children with Additional Needs

Declaration

Application Fee