South Gippsland - 2 Step Application Form

Deferral Form

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Please complete this form to register your child for three-year-old or four-year-old kindergarten in South Gippsland Shire. The information collected in this form will be used to allocate your child to a kindergarten service. Please complete a registration form for each child you would like to register for kindergarten.

To complete the registration form you will need your child’s up to date Immunisation History Statement and, if you hold a concession card, the reference number and expiry date.

This is not an enrolment form. After you receive a kindergarten offer your kindergarten will provide you will an enrolment form to complete.

A full list of participating kindergartens and their proposed programs are on Council's website.

Registration Dates

To receive a first round offer, registrations must be lodged by 30 June.

If you live out of South Gippsland Shire, and your preferred kindergarten is not your closest kindergarten, offers will not be made until third round.

	Date	Offers
First round	1 May - 30 June	First round offers made in early August
Second round	1 July - 31 August	Second round offers made in early October
Third round	Processed on a weekly basis following acceptance of second round offers

Priority of Access

South Gippsland Shire prioritises the inclusion of children with additional needs, children of Aboriginal and Torres Strait Islander background, asylum seeker and refugee families with an appropriate visa, children known to Child Protection and children applying for a second year of kindergarten in line with the Department of Education policy. Families that demonstrate that they have a child in one of these categories will be allocated to a kindergarten program as a high priority.

Following the Department of Education Priority of Access, allocations are made in accordance with the Kindergarten Central Registration Guidelines.

If you have any questions, need help completing this form or require an interpreter, please contact the Kindergarten Registration team on 5662 9200, kinder@southgippsland.vic.gov.au or visit www.southgippsland.vic.gov.au/kinder.

What year would you like your child to commence kindergarten? *

What program type is this registration relevant to?*

3 Year Old Kindergarten

If your child was born between 1 January and 30 April you have the choice to send your child to kindergarten next year, in the same year they turn 3, or the following year, in the year they turn 4.

Due to staffing requirements, you child may not be able to start attending kinder until after their third birthday. This may mean that some children may not start attending their kinder program until part-way into Term 1.

Children are generally only eligible for two years of funded kindergarten. When your child starts kindergarten directly relates to the age they will start at primary school. When enrolling at Three-Year-Old Kindergarten, we encourage families to plan ahead and consider the age they would like their child to start at school.

If you would like to discuss the readiness of your child to start kindergarten, please contact an early childhood educator, Maternal and Child Health Nurse or Council to speak with the Pre-School Field Officer. If your child is born between 1 January and 30 April, we will be in contact with you to discuss your options for starting kindergarten.

Has your child already attended a funded three year old kindergarten program?*

YesNo

Are you applying for a second year of 4 Year Old Kindergarten for your child as recommended by their teacher and approved by the Department of Education and Training?*

YesNo

Which kinder is your child currently attending?*

Are you applying for a second year of funded 4 year old kindergarten?*

YesNo

Which kindergarten is your child currently attending?*

Has your child already attended a funded four year old kindergarten program?*

YesNo

Where did your child attend 4 year old Kindergarten Program?*

Has the second year of four year old kindergarten for your child been recommended by their current kindergarten teacher and approved by the Department of Education and Training?*

YesNo

It is a requirement that all paperwork approving the second year of kindergarten must be provided to the kindergarten before commencing.

Children are only eligible to attend one year of funded four year old kindergarten.

A second year of funded Four-Year-Old Kindergarten will be considered when a child shows delays in key areas of learning and development that are supported by their current kindergarten teacher and approved by the Department of Education and Training.

This application cannot proceed.

Children are only eligible to attend one year of funded three year old kindergarten as set out by the Department of Education and Training.

Please put a registration in for four year old kindergarten or phone 5662 9200 to speak with SGSC kindergarten registration officer.

Preference One*

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Preference Two*

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Preference Three

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PLEASE SELECT A UNIQUE OPTION FOR EACH PREFERENCE

Concatenate Services

Please indicate your preferred days of week*

Child's Name*

First NameLast Name

What is your child usually called?

Gender*

MaleFemalePrefer to self-describe

Child's Date of Birth*

Warning: Your Application is unable to be accepted at this time.

Based on the Date of Birth for your child, your registration does not meet the age criteria for the year you have requested.

Child's Residential Address*

Street Address

Street Address Line 2

CityState

Post Code

Primary language spoken at home*

Does the family require an interpreter?*

Does your child identify as Aboriginal/Torres Strait Islander?*

AboriginalTorres Strait IslanderBothNone of the above

Parent / Guardian 1*

First NameLast Name

Relationship to the child*

Phone Number*

Mobile preferred

Email*

Please Note: You will be notified of all correspondence via email

Would you like to add a second parent / guardian?*

YesNo

Parent / Guardian 2*

First NameLast Name

Relationship to the child*

Parent / Guardian 2 Address*

Same as parent / guardian 1Different to parent / guardian 1

Phone Number*

Mobile preferred

Email*

Please Note: Parent 2 is registering for enquiry purposes only. No placement correspondence will be emailed directly for actioning.

Under the ‘No Jab, No Play’ legislation, a kindergarten service CANNOT confirm a child’s enrolment until the kindergarten provider has been provided with evidence that the child meets one of the following:

Up to date with all vaccinations that are due for their age, or that they are able to receive.
Are on an approved catch up schedule.
Meet the requirements for the 16 week “support period.”

An Immunisation History Statement from the Australian Immunisation Register (AIR) is the only form of documentation accepted and must be submitted with this registration form.

You can get your Immunisation History Statement straight away by accessing your medicare online account via my.Gov.au. You can also call the AIR enquiries line on 1800 653 809 and request a copy of your immunisation history statement. It can take up to 14 days to arrive in the post.

If you are unable to attach the Immunisation History Statement please contact the Kindergarten Registration team on 5662 9200 for assistance.

If you child is not up to date with their immunisations, you can contact your health professional or go to South Gippsland Immunisation sessions to book in to a Free Council immunisation session. If your child is not up to date with their immunisations or on a catch up schedule, they will not be able to start kindergarten. Refer to the Fact Sheet for more information.

Has your child received all the recommended immunisations according to the National Health and Medical Record Council?*

YesNo

Please attach a copy of your child's most recent Immunisation History Statement*

What date is your child due for their next immunisation? Date must be in the future. If your child is not due for any more immunisations please leave blank

Answering the following questions helps us allocate families to kindergarten places in accordance with the Department of Education Priority of Access and the Kindergarten Central Registration Guidelines.

Please indicate if you are eligible for one of the following concessions, or meet one of the following criteria:

Health Care Number*

Health Care expiry date*

Pensioner Number*

Pension Card Expiry Date*

Does your child have any additional needs*

YesNo

If yes, please specify*

max 255 characters

Is your child registered with a specific Support service / agency?*

YesNo

Name of support service / agency*

max 255 characters

Please provide details of your case workers name and contact details*

max 255 characters

Is your child or family known to child protection or connected with the Department of Families, Fairness and Housing or any other support services (eg. Orange Door, Anglicare, Uniting)? *

YesNo

Has your child or an older sibling attended the service of your first preference in the last 3 years?*

YesNo

Are you a resident of the South Gippsland Shire?*

YesNo

Is your first preference kindergarten the closest funded kindergarten program to your residential address?*

YesNo

As you live outside of South Gippsland Shire, you will not receive a kindergarten offer until third round. We encourage you to also register for a kindergarten place within your municipality. Please refer to the Kindergarten Central Registration Guidelines for more information.

Do you believe your application should receive special consideration?

YesNo

Please provide details regarding the special consideration request.

max 200 characters0/200

child_proximity*

YesNo

Would you like to provide any further information about your child?

By submitting this registration form, I understand and agree to the following:

I have read all information provided in this registration form.
I understand that when the offer of a kindergarten place is received, a response must be returned by the due date specified.
I agree to be contacted by the Preschool Field Officer regarding my choice of kindergarten year if my child’s date of birth falls between January 1st and April 30th.
I will notify South Gippsland Shire Council if I will not be available to receive an email as indicated on this form.
I understand that my child can only be enrolled in one funded kindergarten program at one time.
I have attached a copy of Immunisation History Statement.

Privacy Notification

The personal information requested on this registration is collected by South Gippsland Shire Council for the provision of central registration placement for early childhood education and care services in the region. This information will be used by South Gippsland Shire Council for that primary purpose and/or directly related purposes, e.g. placement and transition of children to kindergarten etc. All information will be treated confidentially. South Gippsland Shire Council may disclose information compiled to relevant Government and Kindergarten Service Providers for the purpose of registration, enrolment and kindergarten funding. Additional information gathered about children’s special needs will be used to support the transition process to kindergarten for these children. Information gathered may be used for the purpose of equitable distribution of places across all kindergarten programs.

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Kindergarten Preferences

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Allocation Criteria

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