Wellington Application and PPF Form

Wellington Shire Council

Central Registration for Funded Kindergarten
Deferral Form

YesNo
Flag
To be eligible for three or four-year-old kindergarten children must turn three or four by 30 April in the year they commence. Please note that children may not be able to commence kindergarten until they turn three. Check with the kindergarten for more information.
Child's Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
Child's Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Primary language spoken at home*
Does the child require an interpreter?*

YesNo
Is the child of Aboriginal or Torres Strait origin?*
Is your child a twin?*

YesNo
Parent/Guardian/Grandparent/Legal Carer Details
Parent / Guardian / Grandparent / Legal Carer 1*

First NameLast Name
Relationship to the child*
Parent / Guardian / Grandparent / Legal Carer 1 Address*

Same as child's addressDifferent to child's address
Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Phone Number*
Mobile preferred
Email*
Please Note: You will be notified of all correspondence via email
Would you like to add a second Parent / Guardian / Grandparent / Legal Carer?*

YesNo
Parent / Guardian / Grandparent / Legal Carer 2*

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

Same as parent / guardian 1Different to parent / guardian 1
Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Phone Number*
Mobile preferred
Email*
Please Note: You will be notified of all correspondence via email
Additional information about your child
By completing the following information, you will help our team support your family. This information will also be used to assess priority of access for a kindergarten placement
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 QuadrupletsCurrent or expired ImmiCard
Health Care Number
Health Care expiry date*

DayMonthYear
Pensioner Number
Pension Card Expiry Date*

DayMonthYear
Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found here.
Does your child have any additional needs*

YesNo
If yes, please specify*
max 255 characters
Is your child registered with a specific Support service / agency?*

YesNo
Name of support service / agency*
max 255 characters
Please provide details of your case workers name and contact details*
max 255 characters
Is this child or family known to child protection?*

YesNo
Are there any court orders relating to the powers, duties, responsibilities, or authorities of any person in relation to the child or access to the child?*

YesNo
Please attach a copy of relevant documentation

Browse Files
Max 10MB total file size Cancelof
Kindergarten and Timetable Information

Please note: timetables may be subject to change
Kindergarten Preferences

Funded sessional kindergarten registrations are prioritised based on the Victorian State Government's Kindergarten Guidelines, residence in the shire and prior connection to the service of your first preference
What year would you like your child to commence kindergarten? *
What program type is this application relevant to?*

Wellington Shire Council

Child's Details

Parent/Guardian/Grandparent/Legal Carer Details

Additional information about your child

Kindergarten and Timetable Information

Kindergarten Preferences

Second Year of 4 Year Old Funding

Prior Connection

Authorisation and Declaration