Brimbank Registration Form

Brimbank City Council

Central Registration
Registration is based on criteria in the Brimbank Kindergarten Registration Policy.

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

Please note if your child is too young to register, you can access our Expression of Interest form here.

This form will put you on our system, and we will contact you in the year before your child starts kindergarten to register.
Deferral Form

YesNo
Flag
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?*
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
By completing the following information, you will help our team support your family. This information will also be used to access priority of access for a kindergarten placement
Is your child known to Child Protection, Orange Door/Child FIRST 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:
Does your child/family have a case manager / family support worker?*

YesNo
Name of support service / agency*
max 255 characters
Please provide details of your case workers name and contact details*
max 255 characters
Child/Sibling Name*
eg. Billie Smith
Year*
Child/Sibling Name
eg. Billie Smith
Year
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
What year would you like your child to commence kindergarten? *
What program type is this registration relevant to?*
Preference One*
Preference one 2024
Preference Two
Preference two 2024
Preference Three
Preference three 2024
Please select a unique service for each preference.

Collapse Stopper
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.
Agreement

I declare that I have read and understood the above procedure and agree for this registration to be considered under these terms. I understand that the personal information provided on this registration form is for Brimbank City Council Kindergarten Registration and will be shared by Council for the purpose of 3 & 4 year old Registrations. I acknowledge that I may apply to Council for access to or amend information contained on the registration form.
Stop Automatic Send of Notification email to family?
token
internal_hide

Yes
show_preferences_only

Yes
form_name
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
Already Paid?

Yes
DNUprogramType
DNUCare Period
Should be Empty:

Brimbank City Council

Child's Details

Parent/Guardian Details

Priority of Access for Kindergarten

Kindergarten Preferences

Privacy Statement and Agreement