Palm Beach Kindy

Palm Beach Kindy

Waitlist Form
Deferral Form
Program Type
Child's Name

First nameLast name
Gender
Child's date of birth

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

Postcode
Please note: You have provided a non-NSW address. Palm Beach Kindy is located in a suburb of Sydney, NSW. Please check that you are applying for the correct preschool/kindy.
Preferences for Care
What year does this registration apply for?

What is your preferred number of days? Please note: typically children that are new to the Kindy start on 2 days per week while older children may be offered 3 days per week.
Preference 1
Preference 2
Additional Information
Does your family hold one of the following concession cards?
Health Care Number
Health Care expiry date

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Please attach a copy of the Health Care Card

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Pensioner Concession Card Number
Pensioner Concession Card expiry date

DayMonthYear
2 digit day, 2 digit month, 4 digit year
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
2 digit day, 2 digit month, 4 digit year
Please attach a copy of the Veterans Card

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Does this child identify as Aboriginal / Torres Strait Islander?
Does your child have any additional needs?
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?
NDIS Number:
Will your child require additional support in understanding and communicating in English language at preschool?
Language used by your child (other than English):
Is your child at risk of harm?
Does this child have a sibling who has previously attended this preschool?
Please enter sibling details (First Name, Last Name, Year of Attendance)
Waitlist Fee

Send Notification?
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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
4 digit year, 2 digit month, 2 digit dayDate
Age at 31July starting year
ATSI Output
HCC Output
PCC Output
DVA Output
Concessions Calculator
Concessions
EF Item_ [Add Item Number]
payment_payrix
Current Date

YearMonthDay
4 digit year, 2 digit month, 2 digit dayDate
Copy Attendance Year for calcs
token
Should be Empty:

Group	Days Of Week	Start Time	End Time
2 Day Program	Monday	9:00am	3:00pm
2 Day Program	Tuesday	9:00am	3:00pm
3 Day Program	Wednesday	9:00am	3:00pm
	Thursday	9:00am	3:00pm
	Friday	9:00am	3:00pm

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Preferences for Care

Additional Information

Waitlist Fee

Waitlist Fee*

Waitlist Fee