East Gippsland - Pre-Registration Form

Permission to Connect - Pre-Registration Form

East Gippsland Shire Council
Deferral Form

Yes
The Central Registration Service for Funded Kindergarten is administered by the East Gippsland Shire Council on behalf of participating sessional kindergarten services.

This is an expression of interest form only and does not guarantee a kindergarten placement.

East Gippsland Shire Council will contact you prior to your child attending kindergarten for details on how you can submit your child’s registration.

All information collected will be maintained in accordance with Council's Information Privacy Policy.
Child Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
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?*

YesNo
Due to the State Government policy No Jab No Play your child may not secure an enrolment place in a funded Kindergarten program if proof of immunisation cannot be provided.
Parent Details
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Parent / Guardian Date of Birth*

DayMonthYear
Address*

Street Address

Street Address Line 2

CityState

Post Code
Phone Number*
Email*
Please Note: You will be notified of all correspondence via email
Expression of Interest
What year would you like your child to commence kindergarten? *
What program type is this application relevant to?*
Your application for {child_Name} is a pre-registration to attend kindergarten within the East Gippsland Shire in {service-preferences_care-period}, this will help our council and services plan their future kindergarten programs.
Declaration
Already Paid?

Yes
Child_Address

Street Address

Street Address Line 2

CityState

Post Code
Should be Empty:

Permission to Connect - Pre-Registration Form

Child Details

Immunisations

Parent Details

Expression of Interest

Declaration