Peter Pan Preschool

Peter Pan Preschool

Waitlist Form
Deferral Form

Yes
Program Type
Child's Name*

First nameLast name
Gender*

MaleFemale
Child's date of birth*

DayMonthYear
Parent / Guardian 1*

First nameLast name
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*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferences for Care
What year does this registration apply for?*
Peter Pan Preschool will be enrolling children 3 days per week based on the Department of Education requirements below.
We are offering set day options so that children make better connections with each other. Please choose ALL options that you would consider:

Monday, Tuesday, WednesdayWednesday, Thursday, FridayMonday, Tuesday, ThursdayTuesday, Thursday, FridayMonday, Wednesday, FridayNone of the above
What days of care are you interested in? (please select all that are possible)*

MondayTuesdayWednesdayThursdayFriday
We are offering set day options so that children make better connections with each other. Please choose ALL options that you would consider:

Monday, Tuesday, WednesdayWednesday, Thursday, FridayMonday, Tuesday, ThursdayTuesday, Thursday, FridayMonday, Wednesday, FridayNone of the above
What days of care are you interested in? (please select all that are possible)*

MondayTuesdayWednesdayThursdayFriday
We offer both a Standard Hours and an Extended Hours Program at Peter Pan Preschool. Please note that the Extended Hours Program incurs additional fees per day. Please indicate your preference below:

Standard Hours: 9am - 3pm

Extended Hours: 8:30am - 3:15pm
Please indicate your preference*
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 additional needs?*

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*
Will your child require additional support in understanding and communicating in English language at preschool?*

YesNo
Language used by your child (other than English):*
Is your child at risk of harm?*

YesNo
Can you provide details of risks eg. such as domestic violence/ abuse/ neglect/ self harm*

0/255
Does your child have any allergies?*

YesNo
Please provide details (allergies and treatment)*

0/255
Does your child have asthma?*

YesNo
Please provide details (including any medication requirements)*

0/255
Is your child toilet trained?*

YesNo
Please provide details*

0/255
Send Notification?*
Payment Name
Amount
Calculated Amount for Stripe Widget
Payment Type
alreadyPaid
form_name
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Program type*
31July in year of commencement
31 July in year of commencement convert to date format

YearMonthDay
Date
Age at 31July starting year
ATSI Output
HCC Output
PCC Output
DVA 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)
EF Item_ [Add Item Number]
payment_payrix
Current Date

YearMonthDay
Date
Copy Attendance Year for calcs
Should be Empty:

Preferences for Care

Additional Information