St Peter's Preschool Tamworth

St Peter's Preschool Tamworth

Application Form
If you would like to place your child on the waitlist at St Peter's Preschool Tamworth please complete the following form. Please Note: we will accept applications anytime in the year your child turns two.
Deferral Form

Yes
Program Type
Child's Name*

First nameLast name
Gender*

MaleFemaleUnspecified
Child's date of birth*

DayMonthYear
Please attach proof of age*

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Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Parent / Guardian 1*

First nameLast name
Relationship to the child*
Phone Number*
Email*
Please note: you will be notified of all correspondence via email. This email will be used for all future correspondence unless otherwise advised.
Address*

Same as childDifferent address
Address*

Street Address

Street Address Line 2

CityState

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

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Phone Number*
Email*
Please Note: You will be notified of all correspondence via email
Address*

Same as childDifferent address
Address*

Street Address

Street Address Line 2

CityState

Post Code
Language/s spoken at home:*
Attendance Preferences
What year does this registration apply for?*
Will your child be eligible for school in the year following the year selected above?*

YesNo
Would you prefer 2 or 3 days of care?*
Would you prefer 2 or 3 days of care?*
You are eligible for 2 days of care, please indicate all prefered days below
Please indicate your preferred days (select all that apply):*

MondayTuesdayWednesdayThursdayFriday
Please indicate your preferred days (select all that apply):*

MondayTuesdayWednesdayThursdayFriday
Additional Information
Does your family hold one of the following concession cards?

Health Care Card (Where the child is named as a dependent)Pensioner Concession Card (Where the child is named as a dependent)Veteran Card
Health Care Number*
Health Care expiry date*

DayMonthYear
Please attach a copy of the Health Care Card*

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Pensioner Concession Card Number*
Pensioner Concession Card expiry date*

DayMonthYear
Please attach a copy of the Pensioner Concession Card*

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Department of Veterans Affairs Number*
Department of Veterans Affairs expiry date*

DayMonthYear
Please attach a copy of the Veterans Card*

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

NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander
Does your child have any diagnosed additional needs/differing ability?*

YesNo
If yes, please specify:*

0/255
Which of the following relevant professionals made the assessment?*
If 'Other', please provide the profession*
Please attach a copy of the assessment or letter*

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Does your child have a NDIS number?*

YesNo
NDIS Number:*
You are encouraged to discuss your child's needs with the educator when your child's place is confirmed.
Will your child require additional support in understanding and communicating in English language at preschool?*

YesNo
Language used by your child (other than English):*
Please provide details:*

0/250
Is your child at risk of harm?*

YesNo
Immunisation

Children must be up to date with their scheduled immunsations in order to be enrolled in Preschool.

Please note: Only Immunisation History Statements from the Australian Immunisation Register will be accepted as evidence of immunisation.
Are your child's immunisation up to date?*

YesNo
In order for your child to attend Preschool, your child's immunisations must be up-to-date.
Please upload a copy of your child's Immunisation History Statement*

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Has your child had, or do they currently have, a sibling attending this preschool?*

YesNo
Name/s and Year/s attended*
eg. Sally Smith, 2010
Is your child attending another Early Childhood Education and Care Service?*

YesNo
Please provide details:*
31July in year of commencement
31 July in year of commencement convert to date format

YearMonthDay
Date
Age at 31July starting year
What program type is this application relevant to? *
Send Notification?*
Payment Name
Amount
Payment Type
Payment Reference Number
alreadyPaid
HCC Output
PCC Output
DVA Output
ATSI Output
Concessions Calculator
Concessions

Aboriginal or Torres Strait IslanderBridging visa A-E for humanitarian or refugee visaCommonwealth Health Care CardCommonwealth Pensioner Concession CardCurrent or expired ImmiCardDepartment of Veterans Affairs (DVA) Gold Card or White CardEmergency Rescue visa (subclass 203)Global Special Humanitarian visa (subclass 202)Humanitarian Stay visa (subclass 449)In-country Special Humanitarian visa (subclass 201)Protection visa (subclass 866)Refugee visa (subclass 200)Safe Haven Enterprise visa (subclass 790)Temporary Humanitarian Concern visa (subclass 786)Temporary Protection visa (subclass 785)Triplets or QuadrupletsWoman at risk visa (subclass 204)
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Current Date

DayMonthYear
Date
Copy Attendance Year for calcs
Should be Empty:

Attendance Preferences

Additional Information