Brimbank Registration Form

Brimbank City Council

Central Registration
Registration is based on criteria in the Brimbank Kindergarten Registration and Enrolment Guideline.

Registration forms in languages other than English

Kindergarten eligibility

Enter your child's date of birth in the starting age calculator to check if they are eligible for 3 or 4 year old kinder.

Please note children are unable to repeat 3 year old kinder and will progress directly to 4 year old kindergarten in the following year.

Starting age calculator

A Kindergarten Registration Application is to be completed the year before your child starts kindergarten.

If your child is too young to register, an Expression of Interest can be completed here.
Deferral Form

YesNo
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Child's Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleOther
Child's Date of Birth*

DayMonthYear
Child's Residential Address*
Parent/Guardian Details
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Parent's Residential Address
Phone Number*
Mobile preferred
Parent Email*
All correspondence will be sent to this email address
Parent Country Of Birth*
Does the family require an interpreter?*
What language?
Would you like to add a second parent / guardian?*

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Parent/ Guardian 2 Residential Address
Phone Number*
Mobile preferred
Email*
Parent Country Of Birth*
Priority of Access for Kindergarten
Kindergarten offers are processed in line with the Victorian Department of Education’s priority of access criteria. Kindly complete the below information which will enable Kindergarten team to identify eligibility criteria that your child meets.
Is your child known to Child Protection, or in an Out of Home Care arrangement including kinship care?*

YesNo
Does your child/family have a case manager / family support worker?*

YesNo
Please provide details of your case workers name and contact details*
max 255 characters
Do you or your child identify as Aboriginal or Torres Strait Islander?*

AboriginalTorres Strait IslanderBoth Aboriginal and Torres Strait IslanderNo not Aboriginal nor Torres Strait Islander
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, and is in the process of applying for a Refugee or Humanitarian 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
Concession card / visa expiry date*

DayMonthYear
Does your child have any additional needs. e.g a specific developmental delay or disability*

YesNo
Please specify the type of additional needs*
Details of additional needs*
max 255 characters
Please indicate if any of these are relevant for you child:

Holds a Child Disability Health Care CardHas been previously approved for Kindergarten Inclusion Support PackageReferred by: The National Disability Insurance SchemeReferred by: Early Childhood Intervention ServiceReferred by: Preschool Field OfficerReferred by: Maternal and Child Health nurse
Does your child/family have a case manager / family support worker?*

YesNo
Name of support service / agency*
max 255 characters
To support fair and equitable access to kindergarten, Brimbank residents will be considered for priority access should they have any risk factors such as:
- A parent or child has a life threatening or debilitating illness or disease
- A parent who has a disability, diagnosed mental illness or drug and/or alcohol dependency
- A court orders that limit choices for kindergarten
- Risk of family violence
- Risk of homelessness
You can contact Kindergarten team on 9249 4000 if you prefer to discuss.

Parents/guardians may have to submit document evidence to confirm the details supplied above.

Please note: it must be a diagnosed illness with a specialist referral and management plan. GP’s referral to Mental Health care plan does not fall in special circumstance.
Does your family have special circumstances?

YesNo
Please specify your special circumstance*
Kindergarten Preferences

Funded sessional kindergarten registrations are prioritised based on the Victorian State Government's Kindergarten Guidelines, the child's residential proximity and prior connection to the service of their first preference
Please find attached a link a list of Kindergartens with Addresses and Map
Kindergartens in Brimbank Map and Addresses

Due to the introduction of FREE kindergarten, there are limited spaces in some areas and there is no guarantee that your child will get a place. To maximise your chances, please select up to 3 kindergarten preferences.
What year would you like your child to commence kindergarten? *
Select 3 Year Old or 4 Year Old Kindergarten*

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Privacy Statement and Agreement
Privacy Statement

The information collected through this form will be used by Brimbank City Council to allocate a kindergarten place for your child and for the purpose of communicating any and all associated early learning services to you. This information will be provided to Brimbank Kindergartens, Brimbank Staff, Contractors and any other relevant consultants, agents or affiliated parties where the information is required for the purpose outlined. The data will be kept confidential and identifying information will not be disclosed for any purpose, unless required by law. Parents/guardians of enrolled children can access to seek correction of their information and that of the child upon request.

Document Audit

If there are more registrations than available places, Council staff will complete a random document audit. In this case, parents/guardians may be required to submit documents to confirm the details that they have supplied.
Stop Automatic Send of Notification email to family?
Test Form

Yes
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Yes
show_preferences_only

Yes
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Offer_Response
Surpress Notifications
Program Type
Requires Interpreter

YesNo
Date

DayMonthYear
Date
Cutoff date calculator
Cutoff Date

DayMonthYear
Date
Age as at cutoff
ineligible to apply
Token
Already Paid?

Yes
DNUprogramType
DNUCare Period
DNU - Please indicate if any of these are relevant for you child:
Should be Empty:

Brimbank City Council

Child's Details

Parent/Guardian Details

Priority of Access for Kindergarten

Kindergarten Preferences

Privacy Statement and Agreement