Nillumbik Preschool Application Form

Nillumbik Preschool Application Form
If you would like to place your child on the waitlist at a Nillumbik Kindergarten please complete the following form.

Please Note: we will accept applications one year before your child is eligible to attend 3-year-old preschool, or two years before your child is eligible to attend 4-year-old preschool.

Funded kindergarten registrations are prioritised based on Nillumbik Shire Council’s policy and the Victorian Department of Education Priority of Access Guidelines.

When completing this registration form you’ll need to provide information on your child’s date of birth and where relevant:
That you or your child has a current Health Care or Pension Card
Your child’s residential address

Please note, this is a registration form only and does not guarantee a kindergarten placement.
Deferral Form

Yes
Child's Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleOther
Child's Date of Birth*

DayMonthYear
Please upload a copy of your child's birth certificate, passport or immunisation certificate.*

We only accept files in JPG or PDF format. Maximum file size is 1GB
Cancelof
Preferences
Please indicate if your child will be attending 3 Year Old or 4 Year Old Preschool.*
What year would you like your child to commence 3 Year Old kindergarten?*
What year would you like your child to commence 4 Year Old kindergarten?*
What year would you like your child to commence kindergarten? (internal)*
Would you also like to add an application for 4 Year Old Kindergarten at this time?*

YesNo
Following year program type*
Preference One*
Please note: at least one preference is mandatory, however you can add up to three by adding a second and third preference below
Preference one
Preference Two
Preference two
Preference Three
Preference three
Please select a unique option for each preference.
Please note: Based on the Date of birth you have provided, your child is not within the correct age bracket to commence/attend Preschool in the year you have selected. Please contact us if you wish to discuss further.
Parent / Guardian 1's Details
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Parent / Guardian 1 Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Is the Parent 1 / Guardian Address the same as the Postal Address?*

YesNo
Postal Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Mobile Number*
Email*
Please Note: You will be notified of all correspondence via email

End Hide Part 2
Registration Fee

A non refundable registration fee is payable for all applications.
Already Paid?

Yes

Captcha Verification*
Would you like to pause the send of a notification email for this change?

YesNo
Send Notification email for this change?
Payment Name
3 or 4 year old Amount
3 and 4YO Amount
Total Amount
Payment Type
Surpress Notifications
Payment Reference Number
Todays Date

DayMonthYear
Date
Cutoff date calculator
Cutoff Date

DayMonthYear
Date
internal_hide
Age as at cutoff
ineligible to apply
sibling details
Part 2 Rego
hideFamily
EOI Year
Part 2 Year
form_name
Program Type Input
token
Should be Empty:

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

Nillumbik Preschool Application Form

Child's Details

Preferences

Parent / Guardian 1's Details

Priority of Access

Authorisation and Declaration

Privacy Notice

Disclaimer

Registration Fee