Palm Grove Preschool - Application Form

Palm Grove Preschool Application Form
If you would like to place your child on the waitlist at Palm Grove Preschool please complete the following form. Please Note: we will accept applications anytime in the year your child turns two. At the end you will be asked to pay a non-refundable $45 registration fee via direct funds transfer.
Deferral Form
Child's Name

First NameLast Name
Gender
Child's Date of Birth

DayMonthYear
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:
What year would you like your child to commence kindergarten?
What program type is this application relevant to?
Service Preference 1
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?
Kinder Fee Subsidy
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:
Does this child have a sibling who has previously attended this kindergarten?
Registration Fee
A $45 non-refundable waitlist fee is payable for applicants.
If you wish to seek an exemption from this fee due to priority access, please contact the administration officer at admin@palmgrovekinder.com.
Payment can be made via direct funds transfer using the following details:

Total Payable: $45
Account Name: Palm Grove Preschool Centre Inc.
BSB: 633000
Account Number: 173349408
Payee Description: Child’s Name
Payment Reference Number
Date Paid

DayMonthYear
Date
Payment Name
Amount
Payment Type
Already Paid?
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Form Name
Send Notification?
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Palm Grove Preschool Application Form

Enrolment & Immunisations

Kinder Fee Subsidy

Other Information

Registration Fee