Wyndham City Council - Integrated Registration Form

Wyndham Central Registration

Kindergarten Registration Form.
IMPORTANT – PLEASE READ

To update or make any changes to an existing kindergarten registration, please
contact Child and Family Support on 1300 370 567 or via email at
KinderRegistrations@wyndham.vic.gov.au.

PLEASE DO NOT COMPLETE A NEW REGISTRATION
What Kindergarten year is this registration for? *
What kindergarten year is this registration for? *
Mapped Care period *
What program type is this application relevant to?*
YesNo
Flag
Child's Details
Child's Name (as stated on their birth certificate)*

Legal First Name,Legal Last name
Child's Date of Birth*

DayMonthYear
Please Note:
- Families with children born between January and April can choose which year to start Three-Year-Old Kindergarten. These children can start in the same year they turn 3, or in the year they turn 4 years of age.
  
  The age your child starts at kindergarten directly relates to the age they will start at primary school. When registering for Three-Year-Old Kindergarten, we encourage families to consider the age they would like their child to start at school.
  
  For more information about when to start kinder visit https://www.vic.gov.au/kinder-quick-guide-parents#when-to-start or our website
- Children turning 3 during their kindergarten year can only commence once they have turned 3 years of age.
  
  This may mean that some children may not start attending their kinder program until part-way into Term 1.
For more information, please call Child and Family Support on 1300 370 567
Please Note:
- If your child will turn 6 before they commence school, you must get an exemption from starting school from the Department of Education.
For more information, please call Child and Family Support on 1300 370 567
Warning: Your Application is unable to be accepted at this time.

Based on the Date of Birth for your child, your registration does not meet the age criteria for the year you have requested. Please refer to Starting age calculator
MaleFemaleOther
Please attach confirmation of your child’s date of birth (Optional)

File Upload

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YesNo
Child's Residential Address*
Language spoken at home*
AboriginalTorres Strait IslanderBoth Aboriginal and Torres Strait IslanderNo
If you answered yes, a Child and Family Support Assistant may be in contact with you to discuss Early Start Kindergarten or Pre-Prep Kindergarten Programs available.
Parent / Legal Guardian Details

(Parent 1 will be notified of all communication via email)
Parent / Legal Guardian 1*

Legal Given NameLegal Family Name
Date of Birth: *

DayMonthYear
Date
Relationship to the child*
Parent/Legal Guardian 1 Residential Address*
Phone Number*
Mobile preferred
Email*

Confirmation EmailPlease Note: Parent 1 will be notified of all communications via email. If you do not have an email address please contact Child and Family Support Team 1300 370 567
Parent_1_email
example@example.com
YesNo
Parent / Legal Guardian 1 language*
Dialect
YesNo
Health Care Card Number*
CRN Number
Health Care Card expiry date*

DayMonthYear
Please attach a copy of your Health Care Card *

File Upload

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YesNo
Pensioner Concession Card Number*
CRN Number
Pensioner Concession Card Expiry Date*

DayMonthYear
Please attach a copy of your Pensioner Concession Card*

File Upload

Cancelof
YesNo
DVA Card Number*
DVA Card Expiry Date*

DayMonthYear
Please attach a copy of your DVA card*

File Upload

Cancelof
YesNo
Please attach a copy of your current NDIS plan or support letter from a medical practitioner.*

File Upload

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YesNo
Please provide further details*

0/230
Please attach a copy of your referral letter from a medical practitioner or specialist *

File Upload

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YesNo
Parent / Legal Guardian 2*

Legal First Name,Legal Family Name
Date of Birth: *

DayMonthYear
Date
Relationship to the child*
Parent / Legal Guardian 2 Residential Address*
Phone Number*
Mobile preferred
Email*
YesNo
Parent / Legal Guardian 2 language *
Dialect
YesNo
Health Care Card Number*
CRN Number
Health Care Card Expiry Date*

DayMonthYear
Please attach a copy of your Health Care Card*

File Upload

Cancelof
YesNo
Pensioner Concession Card Number*
CRN Number
Pensioner Concession Card Expiry Date*

DayMonthYear
Please attach a copy of your Pensioner Concession Card*

File Upload

Cancelof
YesNo
DVA Card Number*
DVA Card Expiry Date*

DayMonthYear
Please attach a copy of your DVA card*

File Upload

Cancelof
YesNo
Please attach a copy of your current NDIS plan or support letter from a medical practitioner*

File Upload

Cancelof
YesNo
Please provide further details*

0/230
Please attach a copy of your referral letter from a medical practitioner or specialist*

File Upload

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Priority of Access - Additional information
By completing the following information, you will help our team better support your family. This information will also be used to assess Priority of Access for a kindergarten placement and access to additional hours for priority cohorts (as defined by the Department of Education.

Kindergarten places are allocated to eligible children in line with the Department of Education’s Priority of Access guidelines, as outlined in the Wyndham City Council Central Registration and Enrolment Scheme and Priority of Access fact sheet. For more details, please refer to our webpage Register for Kindergarten.
YesNo
Health Care Card Number or Child Disability Health Care Card Number*
Health Care Card expiry date*

DayMonthYear
Please attach a copy of your child’s Health Care Card*

File Upload
Max 10MB total file size Cancelof
YesNo
YesNo
Pensioner Card Number
E.g CRN Number
Pension Card Expiry Date

DayMonthYear
Please attach a copy of your Pensioner Card

File Upload
Max 10MB total file size Cancelof
YesNo
DVA Card Number
DVA Card Expiry Date

MonthDayYear
Date
Please attach a copy of your DVA Card

File Upload
Max 10MB total file size Cancelof
Refugee visa (subclass 200)In-country Special Humanitarian visa (subclass 201)Global Special Humanitarian visa (subclass 202)Emergency Rescue visa (subclass 203)Woman at risk visa (subclass 204)Humanitarian Stay visa (subclass 449)Temporary Protection visa (subclass 785)Temporary Humanitarian Concern visa (subclass 786)Safe Haven Enterprise visa (subclass 790)Resolution of Status visa (subclass 851)Protection visa (subclass 866)A Bridging visa, and is in the process of applying for one of the above Refugee or Humanitarian visasCurrent or expired ImmiCard
If you answered yes, a Child and Family Support Assistant may be in contact with you to discuss Early Start Kindergarten or Pre-Prep Kindergarten Programs available.
Visa Output
Refugee visa (subclass 200)In-country Special Humanitarian visa (subclass 201)Global Special Humanitarian visa (subclass 202)Temporary Humanitarian Concern visa (subclass 786)Protection visa (subclass 866)Emergency Rescue visa (subclass 203)Woman at risk visa (subclass 204)Humanitarian Stay visa (subclass 449)Temporary Protection visa (subclass 785)Safe Haven Enterprise visa (subclass 790)Department of Veterans Affairs (DVA) Gold Card or White CardBridging visa A-E for humanitarian or refugee visaCurrent or expired ImmiCard
Please attach a copy of your Visa or ImmiCard*

File Upload
Max 10MB total file size Cancelof
YesNo
- YesNo
- Sibling details*
- YesNo
- Sibling details*
- Yes, Three-Year-Old kindergartenYes, Four-Year-Old kindergartenNo
- If yes, please provide details of the Service Name and phone number*
  
  0/255
- National Disability Insurance Scheme Plan (NDIS)A referral by The Preschool Field Officer ServiceMaternal Child Health NurseEarly Childhood Intervention ServiceNone
- If yes, please provide details including Agency Type, support service/ agency case workers name and contact details*
  max 255 characters
- Please attach a copy of your current NDIS Plan or supporting documentation, such as a referral*
  
  File Upload
  
  Cancelof
- YesNo
- If yes, please specify*
  max 255 characters
- Eligible for or undergoing assessment for the National Disability Insurance Scheme (NDIS)Eligible for Early Childhood Intervention Service Continuity of Support (ECIS COS)Is diagnosed with a disability or developmental delay or is undergoing diagnosisPresents with developmental concerns that present barriers to accessing a kindergarten programHas complex medical needs that present barriers to accessing a kindergarten programHas previously accessed Kindergarten or Commonwealth Inclusion Support or similarReferred by a Preschool Field OfficerReferred by a Maternal & Child Health Nurse or similar requestNone of the above
- Please provide further details to help us better understand your child’s needs
  
  0/230
- Please note: If you have selected more than one option in the question above, only 1 supporting document is required.
- Please attach a copy of your current NDIS Plan or support letter from a medical practitioner in the File Upload below.
- Please attach a copy of your referral letter in the File Upload below.
- Please attach a copy of your referral letter from a medical practitioner or specialist in the File Upload below.
- Please attach a copy of your a letter or other evidence from a MCH nurse or similar practitioner in the File Upload below.
- File Upload
  
  Cancelof
- YesNo
- Please Specify*
  
  0/255
- YesNo
- Name of support service / agency and phone number*
  max 255 characters
- YesNo
- Please provide details of your child protection case workers name and contact details*
  max 255 characters
- If you answered yes, a Child and Family Support Assistant may be in contact with you to discuss Early Start Kindergarten or Pre-Prep Kindergarten Programs available.
- If any of the below apply to you, your child, or your family, you may be eligible for additional support to access kindergarten:
  - Known to or having ever had contact with Child Protection
  - Experiencing family violence
  - Have ever had contact with The Orange Door
  - Previously accessed Flexible Support Packages
  - Referred by a Maternal & Child Health Nurse
  - Referred by child and family services
- YesNo
- Known to or having ever had contact with Child ProtectionExperiencing family violenceHave ever had contact with The Orange DoorPreviously accessed Flexible Support PackagesReferred by a Maternal & Child Health NurseReferred by child and family services
- Please attach a copy of the referral letter
  
  File Upload
  Max 10MB total file size Cancelof
- If you answered yes, a Child and Family Support Assistant may be in contact with you to discuss Early Start Kindergarten or Pre-Prep Kindergarten Programs available.
- Both ParentsParent / Guardian 1Parent / Guardian 2Formal Kinship CareFoster CarePermanent CareResidential CareInformal Kinship CareOut of home care arrangement (including kinship care)
- Out-of-home care (OoHC) is a temporary, medium or long-term living arrangement for children and young people who cannot live in their family home.
  
  A Child and Family Support Assistant may be in contact with you to discuss Early Start Kindergarten or Pre-Prep Kindergarten Programs available.
- Please attach any supporting documentation*
  
  File Upload
  E.g Permanent Care Order, Guardianship Cancelof
- YesNo
- Please attached any supporting documentation*
  
  File Upload
  Max 10MB total file size Cancelof
- Child & Family Support will rely on the most recent information provided and may update or speak with Parent/Guardian 1 and/or Parent/Guardian 2 about the details of your child's registration.
  
  Families must notify Child & Family Support of any changes and keep their details up to date throughout registration and attendance at kindergarten.
- If you wish to register another sibling for the same kindergarten and year, after selecting your preferences and submitting this registration, you will need to complete a new registration form in full for your other child.
- P1 eligible?
- P2 eligible?
- input_PPPC
- Pre Prep Priority Cohort
- Kindergarten Preferences
- You will be able to select your preferred kindergartens and groups once you click “Next” at the bottom of this page.
  
  To assist you with this process, please download the Important Information and Preference Selection Guide below, which provides step-by-step instructions for completing the next page.
  
  Please note: Once “Next” is selected, your information will be saved and you will not be able to return to this page.
- Based on your responses, your child is eligible to attend 22.5 hours of kindergarten per week in 2027.
- YesNo
- Days and/or times don’t suit our familyThree 7.5-hour days are too long for my childExisting care arrangements prevent us from accessing a third day
- You will be able to select your preferred kindergartens and groups once you click "Next" at the bottom of this page.
  
  Please select a maximum of 10 preferences from the 15 hour groups.
  
  *Once you have selected your preferred 15-hour groups and submitted your child’s registration, the Child and Family Support team will contact you via email with a link to select your preferences from the 22.5-hour groups.
  
  Preferences can be listed across one service or multiple services.
  
  To assist you with this process, please download the Important Information and Preference Selection Guide below, which provides step-by-step instructions for completing the next page.
  
  Please note: Once "Next" is selected, your information will be saved and you will not be able to return to this page. Please check your information is correct.
- You will be able to select your preferred kindergartens and groups once you click "Next" at the bottom of this page.
  
  Please select a maximum of 10 preferences
  
  Preferences can be listed across one service or multiple services.
  
  To assist you with this process, please download the Important Information and Preference Selection Guide below, which provides step-by-step instructions for completing the next page.
  
  Please note: Once "Next" is selected, your information will be saved and you will not be able to return to this page. Please check your information is correct.
- Authorisation and Declaration
- By submitting this registration form, I understand and agree to the following:
- PRIVACY NOTIFICATION
  
  Your personal and health information and that of your child is being collected by Wyndham City Council for the purpose of planning and delivering access to early education services, while registering for and/or attending kindergarten services on Wyndham City Council’s Central Registration & Enrolment Scheme. Your and your child’s personal and health information will be used and stored by Council to administer the Central Registration & Enrolment Scheme and other early years’ services. Your information will be stored in Council’s customer databases and will be used to identify you when communicating with Council for the delivery of services and information to you. Your information may be shared with kindergarten services, educators, early intervention, and health and welfare service providers for the purposes mentioned.
  By submitting your details, you consent to the collection, use, and disclosure of your and your child's personal and health information.
  
  You and your child’s personal and health information will be handled in accordance with the Privacy and Data Protection Act 2014 (Vic) and Health Records Act 2001 (Vic). For further information about how your personal information is handled, refer to Council’s Privacy Policy (http://www.wyndham.vic.gov.au/privacy-policy).
  
  You may contact Council with concerns about the privacy of your personal information at mail@wyndham.vic.gov.au.
- YesNo
YesNo
crm_orgid
Yes
Yes
Payment Name
Yes
form_name
Form_name_to_trigger_workflow
Offer_Response
crm_orgid
Program Type Input
Care Period Input
Current Date

DayMonthYear
Date
Cutoff date calculator
Cutoff Date

DayMonthYear
Date
Age as at cutoff
ineligible to apply
Total Amount
Payment type
Year
Yes
token
- Type a question
- DNU_Health Care Card Number*
  CRN Number
- DNU_Health Care Card Number*
  CRN Number
- DNU_Please attach a copy of your referral letter from a medical practitioner or specialist.*
  
  Browse Files
  
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- Should be Empty:

Wyndham Central Registration

Child's Details

Parent / Legal Guardian Details

Priority of Access - Additional information

Kindergarten Preferences

Authorisation and Declaration