Surf Coast Shire - Application Form

Kindergarten Central Application Form
Thank you for advising that you wish to decline your kindergarten offer for next year and to remain on the waitlist for an alternative service. Please update your preferred kindergarten below to reflect all kindergartens at which you are willing to accept an offer.
Welcome to the Surf Coast Shire Kindergarten Program online central application form.

Surf Coast Shire Council is the Early Years Management (EYM) that provides service delivery, professional leadership and centralised management for the below kindergarten services.

Kurrambee Myaring Kindergarten (Torquay)
Torquay Kindergarten (Torquay)
Helen M Kininmonth Kindergarten (Winchelsea)
Jan Juc Pre-School
Anglesea Kindergarten
Lorne Kindergarten

Applications are not prioritised by date order. Council operates a priority of access system only if groups exceed capacity.

Priority of access
We support the Department of Education (DE) policy direction that prioritises the inclusion of children with additional needs, children of Aboriginal and Torres Strait Islander background, asylum seeker and refugee families with an appropriate visa, children known to Child Protection and children applying for a 2nd year of kindergarten. Families that demonstrate that they have a child in one of these categories will be allocated to a kindergarten program as a high priority.

Full list of Priority of access criteria is available on our Central Registration and Enrolment Scheme Policy.

Session times and hours for all 3 year-old and 4 year-old kindergarten programs will be determined at the end of first round applications. The decision is based on number of applications received and service capacity.

Three year old kindergarten - Government Funded Program
- Children must be three years old to attend Three-Year-Old Kindergarten.
- Children will only be able to access one year of Government Funded Three-Year-Old Kindergarten.
- Children accessing Three-Year-Old Kindergarten will transition to Four-Year-Old Kindergarten the following year.
- 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 2024, your child will transition to Four-Year-Old Kindergarten in 2025, then school in 2026.
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).
When to start Three and Four-Year-Old Kindergarten
Use the Starting Age Calculator to enter your child's birth date to find out what year they can start Three and Four-Year-Old Kindergarten.

Starting age calculator

No Jab No Play
An Immunisation History Statement from the Australian Immunisation Register is the only documentation accepted by early childhood education and care services for the purposes of confirming a child’s enrolment in their service.

Contact us
If you have any questions regarding the application please contact us via email centralapplication@surfcoast.vic.gov.au
Child's Details
Child's Name*

First NameLast Name
Sex assigned at birth*

MaleFemaleOther
What gender does your child identify as*

MaleFemaleOther
Child's Date of Birth*

DayMonthYear
Child's living arrangement*

Both parentsParent / Guardian 1Parent / Guardian 2Formal Kinship CareFoster CarePermanent CareResidential CareInformal Kinship Care
Language/s spoken at home:*
Is this child Aboriginal or Torres Strait Islander?*

NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander
Is this child or family known to child protection?*

YesNo
Is your child from a refugee or asylum seeker background?*

YesNo
Early Start Kindergarten gives eligible children 15 hours of free or low-cost kindergarten a week for two years before starting school. To be eligible, your child must be three by 30 April in the year they start kindergarten, and:
- is from a refugee or asylum seeker background, or
- identify as Aboriginal or Torres Strait Islander, or
- your family has had contact with child protection.
Do you wish to apply for ESK?

YesNo
Does your child have any additional needs?*

YesNo
If yes, please specify:*

0/255
You are encouraged to discuss your child's needs with the educator when your child's place is confirmed.
Contact Details
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
Does this child have a second Parent / Guardian?*

YesNo
Do you want Parent 2 to have access and permission to view or edit Parent 1's details?*

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*
Does Parent 1 have authority to view and edit Parent 2's details?*

YesNo
Immunisation Details
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 immunisations up to date?*

YesNo
Please attach your child's immunisation history statement*

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Concession Details
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 CardDepartment of Veterans’ Affairs Gold Card or White CardRefugee visa (subclass 200)In-country Special Humanitarian visa (subclass 201)Global Special Humanitarian visa (subclass 202)Humanitarian Stay visa (subclass 449)Visitor Visa (subclass 600)Temporary Protection visa (subclass 785)Safe Haven Enterprise visa (subclass 790)Temporary Humanitarian Concern visa (subclass 786)Protection visa (subclass 866)Emergency Rescue visa (subclass 203)Woman at risk visa (subclass 204)Bridging visas A-E.Triplets or QuadrupletsCurrent or expired ImmiCard
Health Care Number*
Health Care Card Expiry Date*

DayMonthYear
Pensioner Number*
Pensioner Expiry Date*

DayMonthYear
Supporting documentation will need to be sighted at the time of enrolment
Additional Information
Are there any Family Court Orders / Parenting Plans relating to the powers, duties, responsibilities or authorities of any person in relation to the child or access to the child?*

YesNo
1. If there are court orders in place relating to your child, you must bring the original court order/s for staff to see and attach a copy to this enrolment form.

2. If these orders change the powers of a parent /guardian to:
• authorise the taking of the child outside the service by a staff member of the service;
• consent to the medical treatment of the child;
• request or permit the administration of medication to the child;
• collect the child from the service or family day care; and/or
• give these powers to someone else.
Please describe these changes and provide the contact details of any person given these powers in the space below:*
Please attach a copy of order(s) and bring original copy for educators to sight*

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Does the child have a sibling (not multiple birth) who previously attended your preferred kindergarten?

YesNo
Sibling 1 Details*
Sibling 2 Details (Optional)
Do you live or work within the Surf Coast Shire municipality?*

YesNo
Kindergarten Preferences
Date

DayMonthYear
Date
What year would you like your child to commence in kindergarten? *
What year would you like your child to commence in kindergarten? *
What Program Type is this application relevant to?*
Mapped Care Period *
Are you applying for a 2nd year of 4yr old kindergarten?*

YesNo
Have you attended a 3 year old program previously*

YesNo
What Kindergarten is your child currently attending?
Service Preference
Preference One*
Pref One
Preference Two*
Pref Two
Preference Three*
Pref Three
Session Preferences

This information will assist in planning session days and times.
Please indicate your preferred session format (please select all that apply)

3 days: 5 hour sessions each day3 days: 6 hour sessions for 2 days, 3 hour session for 1 day2 days: 7.5 hour sessionsNo preference
Please indicate preferred kinder days:

MondayTuesdayWednesdayThursdayFridayNo preference
Deferral Form

Yes
WARNING: YOUR APPLICATION IS UNABLE TO BE ACCEPTED ONLINE.

Based on the Date of Birth entered for this child, they will not meet the age criteria for Kindergarten Registration. Please contact us via email to discuss centralapplication@surfcoast.vic.gov.au
WARNING: PLEASE SELECT UNIQUE SERVICE PREFERENCES
Send Notification to family?
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Yes
Child Address*

Street Address

Street Address Line 2

CityState

Post Code
current_service_allocated
Same Service Priority
Suppress Notifications
Program Type Input
Care Period Input
Offer Response
form_name
Date

DayMonthYear
Date
Cutoff date calculator
Cutoff Date

DayMonthYear
Date
Age as at cutoff
ineligible to apply
Should be Empty:

Kindergarten Central Application Form

Child's Details

Contact Details

Immunisation Details

Concession Details

Additional Information

Kindergarten Preferences

Service Preference

Session Preferences