Nillumbik Preschool Application Form

Nillumbik Preschool Application Form
Please complete the following form to register your child to attend kindergarten at a preschool service in Nillumbik’s central registration system.

Families are encouraged to register for 3-year-old and 4-year-old kindergarten at the same time.

Before you begin

Before commencing the registration process, please ensure you have the following information:
- Child and parent/guardian (applicant) contact information
- Preschool preferences (we recommend choosing 3 services)
- Supporting documentation applicable to the Department of Education (DE) priority of access and Nillumbik Shire Council’s selection criteria.
We can only provide information to the parents/guardians listed on this registration.

Preschool places are allocated in accordance with the Department of Education (DE) priority of access and the selection criteria set out in Council’s Priority of Access and Offer Policy Guidelines. These guidelines are used to ensure all allocations to 3 and 4-year-old kindergarten through the Preschool Registration Scheme are fair and equitable.

With the introduction of funded kindergarten, we anticipate an increase in registrations for our preschool services which may result in more applications than available places. Families who do not receive a preschool offer will have the option to remain on a waitlist and the Preschool Registrations Team will contact you if a place becomes available.
Deferral Form

Yes
Family 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
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Child Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Is the Parent / Guardian 1's Address the same as the Child's Address?*

YesNo
Parent / Guardian 1 Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Mobile Number*
Email*
Please Note: You will be notified of all correspondence via email
The Department of Education has updated their Priority of Access for 2027. As part of these updates, eligibility has been expanded to better recognise children, parents and carers with additional needs. This includes families who may require extra support to access or participate in kindergarten.
Does Parent / Guardian 1 have a NDIS number or are they undergoing assessment for disability under the NDIS currently?*

YesNo
Does Parent / Guardian 1 have complex medical needs that present barriers to accessing a kindergarten program (supported by a letter from a medical practitioner or specialist)?*

YesNo
Please provide further details*

0/230
Please attach a copy of the assessment or letter*

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Would you like to add a second Parent / Guardian?

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Is the Parent / Guardian 2's Address the same as the Parent / Guardian 1's Address?*

YesNo
Parent / Guardian 2 Residential Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Mobile Number*
Email*
Please Note: You will be notified of all correspondence via email
Does Parent / Guardian 2 have a NDIS number or are they undergoing assessment for disability under the NDIS currently?*

YesNo
Does Parent / Guardian 2 have complex medical needs that present barriers to accessing a kindergarten program (supported by a letter from a medical practitioner or specialist)?*

YesNo
Please provide further details*

0/230
Please attach a copy of the assessment or letter*

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Kindergarten Program
What year would you like your child to commence kindergarten?*
What year would you like your child to commence kindergarten?*
Mapped_Care Period *
Please indicate if your child will be attending 3 Year Old or 4 Year Old Preschool.*
Would you also like to add an application for 4 Year Old Kindergarten at this time?*

YesNo
Following year program type*
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.
Kindergarten Location
Use the map below, which displays all the kindergartens as a green pin, to help you find a service location that meets your needs.

Enter the Year, Program Type (3 or 4-year-old), and your address.
Your address will appear on the map as a blue home icon so you can see where the closest kindergartens to your home are. Click on any of the green pins to display that service’s information.
Kindergarten Preferences
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.
- Nillumbik Priority of Access Allocation Criteria
- Are you currently or intending to be a Nillumbik resident?*
  
  Yes, I am currently a residentYes, I intend to become a resident by the 30th June when registrations closeNo
- Please upload one of the following as your proof of residence.
  - Rates Notice
  - Driver's Licence
  - Utility Bill
- Please attach proof of residency.*
  
  We only accept files in JPG or PDF format. Maximum file size is 1GB
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- Please upload one of the following as your proof of intention to become a resident
  - Contract of Sale or Rental Agreement
- Please attach proof of upcoming residency.*
  
  We only accept files in JPG or PDF format. Maximum file size is 1GB
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- Do you have a connection to Nillumbik Shire through work, study or childcare arrangements?*
  
  YesNo
- Please attach proof of work, study or childcare in Nillumbik.*
  
  We only accept files in JPG or PDF format. Maximum file size is 1GB
  Cancelof
- Is your 1st preferenced preschool the closest preschool to your place of residence?*
  
  YesNo
- Other Connection (work, study, childcare or closest service)*
  
  YesNo
- Does the child have a sibling that previously attended the preschool marked as preference one in the previous 2 years?*
  
  YesNo
- Sibling Details*
- Has this child previously attended 3 year old Preschool at your 1st preferenced 4 Year old preschool*
  
  YesNo
- Additional Information About Your Child
- Priority of Access eligibility, including Pre-Prep eligibility - Department of Education
  
  By providing the following information, you will help our team support your family, and if eligible, provide your child with priority access to a kindergarten place.
- Does your child identify as Aboriginal or Torres Strait Islander?*
  
  NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander
- Do any of the below apply to you or your child?*
  
  Commonwealth Health Care CardCommonwealth Pensioner Concession CardDepartment of Veterans Affairs (DVA) Gold Card or White CardTriplets or Quadruplets or moreNone of the above
- Concessions Output
- Do you or your child hold a Commonwealth Health Care Card?
  
  YesNo
- Health Care Number*
- Health Care Card expiry date*
  
  DayMonthYear
  Date
- Please attach a copy of your Health Care card*
  
  We only accept files in JPG or PDF format. Maximum file size is 1GB
  Cancelof
- Do you or your child hold a Pensioner Concession Card?
  
  YesNo
- Pensioner Concession Card Number*
- Pensioner Concession Card Expiry Date*
  
  DayMonthYear
  Date
- Please attach a copy of your Pensioner Concession card*
  
  Cancelof
- Do you hold a Veterans Affairs Card?
  
  YesNo
- Department of Veterans Affairs Card Number*
- Department of Veterans Affairs Card Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Department of Veterans Affairs card*
  
  Cancelof
- Is this child a multiple birth (triplet or quadruplet or more?)
  
  YesNo
- Do you or your child have, or are you applying for, any of the following visas?
  
  Refugee 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)Resolution of Status visa (subclass 851)Current or expired ImmiCard
- Visa Output
- Please attach a copy of your Department of Visa*
  
  Cancelof
- Concessions Calculator
- Mapped_Applicable Concessions
  
  Refugee 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)Resolution of Status visa (subclass 851)Current or expired ImmiCardCommonwealth Health Care CardCommonwealth Pensioner Concession CardDepartment of Veterans Affairs (DVA) Gold Card or White CardTriplets or Quadruplets or more
- Is this child or family at risk of neglect or abuse?*
  
  YesNo
- If yes, please select from one of the following
- Additional Needs of the child
- Does your child have additional needs requirements?*
  
  YesNo
- Please specify the type of additional needs*
- Details of additional needs*
- Please indicate if any of these are relevant for you child:
- Please upload supporting documents.*
  
  We only accept files in JPG or PDF format. Maximum file size is 1GB
  Cancelof
- Second Year of Funded Kindergarten
  
  Children enrolled in a funded kindergarten program are eligible to access a repeat year of funded 3 or 4 year old kindergarten, only if the early childhood teacher has assessed eligibility for your child to be considered for a second year.
- Is your child applying for a second year of funded {servicevicepreference_program-type}?*
  
  YesNo
- Please provide the name of the current service and a contact phone number.*
  
  0/245
- Additional Information
- Are there any further details/comments you would like to provide at this time?
- Authorisation and Declaration
- Do you wish to receive emails from Nillumbik Family and Children's Services about events, activities or programs*
  
  YesNo
- By submitting this registration form, I understand and agree to the following:
- Privacy Statement
- Nillumbik Shire Council is collecting your information for the purpose of processing your preschool registration. Council will disclose details contained in your application to the allocated preschool Enrolment Officer to enable them to finalise your child’s enrolment. The information will not be disclosed to third parties without your consent unless we are required to by law. At times during the allocation process, Council will contact the applicant via text or email as supplied in this application. You have the right to access and correct your personal information by contacting the Preschool Registrations Team on 9433 3161 or email preschool@nillumbik.vic.gov.au.
- Disclaimer
- Every effort has been made to ensure the information contained in this document is accurate at the time of distribution, however policies and fees are routinely reviewed and changes may have occurred. Visit nillumbik.vic.gov.au/preschool for current fees and forms.
- Captcha Verification*
- Send Notification email for this change?
- Test Form
  
  Yes
- Payment Name
- 3 or 4 year old Amount
- 3 and 4YO Amount
- Total Amount
- Payment Type
- Payment Reference Number
- Todays Date
  
  DayMonthYear
  Date
- Cutoff date calculator
- Cutoff Date
  
  DayMonthYear
  Date
- internal_hide
- Age as at cutoff
- ineligible to apply
- Part 2 Rego
- hideFamily
- EOI Year
- Part 2 Year
- form_name
- Program Type Input
- Care Period Input
- transfers
  
  Yes
- token
- DNU_Child/Sibling Name*
  eg. Billie Smith
- DNU_sibling details
- DNU_Year Attended*
  eg. 2024
- DNU_Surpress Notifications
- DNU_Child/Sibling Name
  eg. Billie Smith
- DNU_Concession card *
  
  DayMonthYear
  Date
- DNU_Do you or your child hold any concessions, current health care card, concession card, humanitarian/refugee or bridging visa?*
  
  YesNo
- DNU_Year Attended
  eg. 2024
- DNU_Please indicate the multiple birth type.
- DNU_Would you like to pause the send of a notification email for this change?
  
  YesNo
- DNU_ 3 Year old previous Preschool name and year of attendance
- Should be Empty:

Nillumbik Preschool Application Form

Family Details

Kindergarten Program

Kindergarten Location

Kindergarten Preferences

Nillumbik Priority of Access Allocation Criteria

Additional Information About Your Child

Additional Information

Authorisation and Declaration

Privacy Statement

Disclaimer