Wellington Shire Council

Permission to Connect - Expression of Interest

Wellington Shire Council
Deferral Form

Yes
The Central Registration Service for Funded Kindergarten is administered by the Wellington Shire Council on behalf of participating kindergarten services.

This is an Expression of Interest form only and does not guarantee a kindergarten placement.

Wellington Shire Council will reach out in the year prior to your child attending kindergarten with details on how you can submit your child’s registration.

All information collected will be maintained in accordance with Council's Information Privacy Policy.
Child Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
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
Due to the State Government policy No Jab No Play your child may not secure an enrolment place in a funded Kindergarten program if proof of immunisation cannot be provided.
Parent/Guardian/Grandparent/Legal Carer Details
Parent / Guardian / Grandparent / Legal Carer 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
Expression of Interest
What year would you like your child to commence kindergarten? *
What program type is this expression of interest relevant to?*
Please indicate the town where you think your child will attend kindergarten*
Consent and Declaration
Protecting your privacy and your personal information is an important responsibility of Council. Our Privacy Policy and Guidelines supports and endorses the Privacy and Data Protection Act 2014, the Information Privacy Principles and national privacy regime.

Wellington Shire Council will only collect personal information which is necessary for performance and functions of Council. In accordance with the Privacy and Data Protection Act 2014, we will not use your personal information for a purpose other than the purpose for which it was collected or disclose your personal information to a third party, including state bodies or authorities (without your consent), except where the secondary purpose is reasonably expected, required by other regulation, or if the release is authorised by law.
Child_Address

Street Address

Street Address Line 2

CityState

Post Code
Offer_Response
form_name
Expression Of Interest Year
Should be Empty:

Permission to Connect - Expression of Interest

Child Details

Immunisations

Parent/Guardian/Grandparent/Legal Carer Details

Expression of Interest

Consent and Declaration