Butterfield House Kindergarten

Butterfield House Kindergarten Application Form
If you would like to place your child on the waitlist at Butterfield House Kindergarten please complete the following form. Please Note: we will accept applications anytime in the year your child turns two.
Butterfield House have a sister kindergarten, Williams House. Would you like us to share these application details for your child with Williams House kindergarten in the event that our waitlist exceeds places available?
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Deferral Form
Child's Name

First NameLast Name
Gender
Child's Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Address

Street Address

Street Address Line 2

SuburbState

Post Code
Parent / Guardian 1

First NameLast Name
Relationship to the child
Address
Address

Street Address

Street Address Line 2

CityState

Post Code
Phone Number
Email
Please Note: You will be notified of all correspondence via email
Would you like to add a second parent / guardian?
Parent / Guardian 2

First NameLast Name
Relationship to the child
Address
Address

Street Address

Street Address Line 2

CityState

Post Code
Phone Number
Email
Please Note: You will be notified of all correspondence via email
Language/s spoken at home:
Does this child have a sibling who has previously attended this kindergarten?
What year would you like your child to commence kindergarten?
What program type is this application relevant to?
Service Preference
Is your child enrolled in a local primary school?
If yes, please provide the name of the primary school
Does this child have a parent/guardian that is a current staff member of Butterfield House or Christian College?
Enrolment & 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?
Kindergarten Fees
Please be aware that Butterfield House does NOT offer Free 3-year-old or 4-year-old Kindergarten Programs, under the Victorian Government Free Kindergarten Scheme. Butterfield House fees are charged termly & paid by families in full via direct debit from their nominated account. Eligible families can access kindergarten Fee Subsidy.
Kinder Fee Subsidy
Do any of the following concessions, or criteria apply
Do any of the following concessions, or criteria apply
Supporting documentation will need to be sighted on commencement at Sample Kindergarten by the Enrolments Officer.

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found at: https://www.education.vic.gov.au/parents/child-care-kindergarten/Pages/how-much-kindergarten-cost.aspx
Other Information
Does your child have any special needs
If yes, please specify:
You are encouraged to discuss your child's needs with the educator when your child's place is confirmed.
Is your child registered with a specific Support service / agency?
Name of support service / agency:
Payment Name
Amount
Payment Type
Payment Reference Number
Already Paid?
Form Name
Would you like to pause the send of a notification email for this change?
Should be Empty:

Butterfield House Kindergarten Application Form

Enrolment & Immunisations

Kindergarten Fees

Kinder Fee Subsidy

Other Information