Baw Baw Shire – Integrated Registration Form

Deferral Form

Yes

If you would like to place your child on the allocation list for a Baw Baw Shire Kindergarten please complete the following form.

Eligibility

Children need to be three years old to attend kindergarten. For children that are turning 3 years of age in February – April a placement can be held. In some cases, a child under the age of 3 child may be able to participate in a limited way following discussion and arrangements with the kindergarten service.

Born Between	Year Eligible for 3YO	Year Eligible for 4YO
01/05/2021 - 30/04/2022		2026
01/05/2022 - 30/04/2023	2026	2027
01/05/2023 - 30/04/2024	2027	2028 (complete EOI)

Children born between January to April are in the youngest sector of the group and may not be quite ready for the expectations of Kindergarten. Families have the choice to defer their kindergarten year to the following year. This would see their child turn 4 during the 3-year-old kindergarten program and 6 in the year they commence school. Children that meet specific learning and developmental criteria may be eligible for a second year of funded kindergarten in either Three-Year Old Kindergarten or Pre-Prep.

If you have questions about deferring your child, or their readiness for Kindergarten, please contact Family & Children’s Services on 5624 2540.

Date

What year would you like your child to start kindergarten? *

What Year Mapped

What program type is this application relevant to?*

Please select the appropriate option from the list below of where your preferred kindergarten is located.

You will have the opportunity later in the application form to nominate your session preferences.

Child's Name*

First NameLast Name

Gender*

MaleFemaleUnspecified

Child's Date of Birth*

Your child is ineligible for {servicevicepreference_program-type} in {service-preferences_care-period} based on the Date of Birth you have entered.

Your child is eligible age for defering their enrolment, please see above message regarding deferral age for more information, to discuss further please call 5624 2540.

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.

Language/s spoken at home:

Is an interpreter required?

YesNo

Parent / Guardian 1*

First NameLast Name

Relationship to the child*

Address*

Street Address

Street Address Line 2

CityState

Post Code

Phone Number*

Email*

Please Note: You will be notified of all correspondence via email, please use an email address that is regularly monitored.

Does Parent / Guardian 1 hold a Commonwealth Health Care Card?*

YesNo

Health Care Number*

Health Care Expiry Date*

Does Parent / Guardian 1 hold a Commonwealth Pensioner Concession Card?*

YesNo

Pensioner Number*

Pensioner Card Expiry Date*

Does Parent / Guardian 1 hold a Veterans Affairs Card?*

YesNo

Department of Veterans Affairs Number*

Department of Veterans Affairs Expiry Date*

Does Parent / Guardian 1 have a NDIS number or are they undergoing assessment for disability under the NDIS currently?*

YesNo

Due to your response of ‘Yes’, we will contact you later in the process to obtain additional information.

Does Parent / Guardian 1 have complex medical needs that present barriers to accessing a kindergarten program (supported by a letter from a medical practitioner or specialist)?*

YesNo

Please provide further details*

0/230

Please attach a copy of the assessment or letter*

Would you like to add a second parent / guardian?*

YesNo

Parent / Guardian 2*

First NameLast Name

Relationship to the child*

Parent / Guardian 2 Address*

Same as parent / guardian 1Different to parent / guardian 1

Address*

Street Address

Street Address Line 2

CityState

Post Code

Phone Number*

Email*

Please Note: Parent 2 is registering for enquiry purposes only. No placement correspondence will be emailed directly for actioning.

Does Parent / Guardian 2 hold a Commonwealth Health Care Card?*

YesNo

Health Care Number*

Health Care Expiry Date*

Does Parent / Guardian 2 hold a Commonwealth Pensioner Concession Card?*

YesNo

Pensioner Number*

Pensioner Card Expiry Date*

Does Parent / Guardian 2 hold a Veterans Affairs Card?*

YesNo

Department of Veterans Affairs Number*

Department of Veterans Affairs Expiry Date*

Does Parent / Guardian 2 have a NDIS number or are they undergoing assessment for disability under the NDIS currently?*

YesNo

Due to your response of ‘Yes’, we will contact you later in the process to obtain additional information.

Does Parent / Guardian 2 have complex medical needs that present barriers to accessing a kindergarten program (supported by a letter from a medical practitioner or specialist)?*

YesNo

Please provide further details*

0/230

Please attach a copy of the assessment or letter*

Are you a resident and / or ratepayer of Baw Baw Shire?*

YesNo

Non Baw Baw Shire residents will not be considered for first round offers unless they can show evidence.

Are you moving to the Shire ?

YesNo

Date Moving to Area*

Add Evidence of moving to Baw Baw Shire*

Applying to attend a specific kinder outside my Municipality ?*

YesNo

You are considered a non resident of Baw Baw Shire. Your application will be accepted and allocated after the 1st round offers have been completed.

P1 Eligible?

P2 Eligible?

Input PPPC

Pre Prep Priority Cohort

Second Year of Funded Kindergarten

Children enrolled in a funded kindergarten program are eligible to access a repeat year of funded 3 or 4 year old kindergarten, only if the early childhood teacher has assessed eligibility for your child to be considered for a second year.

Are you applying for a second year of funded {servicevicepreference_program-type}?*

YesNo

Please provide details of Kindergarten currently attending.*

By completing this information, you will help our team support your family. This information will also be used to assess priority of access for a kindergarten placement.

Does your child identify as Aboriginal / Torres Strait Islander?*

AboriginalTorres Strait IslanderBoth Aboriginal and Torres Strait IslanderNone of the above

Does your child hold a Commonwealth or Disability Health Care Card?*

YesNo

Health Care Number*

Health Care expiry date*

Is this child a multiple birth (triplet or quadruplet or more)?*

YesNo

Do you or your child have, or are you applying for, any of the following visas?

Supporting documentation will need to be sighted on commencement at Kindergarten.

Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found at: www.education.vic.gov.au/childhood/parents/support/Pages/financialassist.aspx

Does your child have additional needs requirements? E.g. a specific developmental delay or disability*

YesUndergoing DiagnosisNo

Please specify*

Does your child have a diagnosed medical condition?*

YesNo

Please specify*

Does this medical condition need to be considered when allocating because placement in a particular group could compromise the child's health? Evidence from a medical practitioner will be required.*

YesNo

Please provide supporting documentation if available*

Have you applied for or are you registered for NDIS funding?*

Yes approvedApplied under reviewNo

Does your child have any additional needs

YesNo

You are encouraged to discuss your child's needs with the educator when your child's place is confirmed.

Child's Living Arrangement*

Is your child registered with a specific Support service / agency?*

YesNo

Name of support service / agency:*

Please provide supporting documentation if available

Is your child or family known to child protection or connected to Department of Families, Fairness and Housing or any other Support Services (eg Orange Door)?*

YesNo

If yes, please select one of the following:*

Please attach a copy of relevant documentation

Max 10MB total file size

Other Details

0/250

In making this application you are:

Acknowledging that the Council accepts this application on behalf of participating kindergartens but gives no guarantee that a place will be available in the kindergarten nominated or in any other kindergarten in the municipality; and
Confirming that if a previous application has been made to Baw Baw Shire Council you agree that your most recent (last) application will be considered only; and
Acknowledging that the Council will be using data from this application for future planning which may include waiting lists between kindergartens.

Privacy notification: The personal and health information collected on this form is being collected by the Council for the purposes of planning current and future kindergarten services in Baw Baw Shire. The information will be used solely by Council and its contract service providers and external Government Agencies for that purpose or a directly related purpose. The information shall remain private and confidential within Council and will only be disclosed to other persons or agencies as consented by the enrolling parent or the authorised parent/guardian. The applicant understands that the personal and health information provided is for the placement of children in kindergarten services in Baw Baw Shire and they may apply to Council's Privacy Officer in writing for access to and/or amendment of the information.

Feedback:

Baw Baw Shire strives to continuously improve our kindergarten enrolment processes. If you have any comments or suggestions about how you found this enrolment form, we would love to hear them!

How easy did you find this application form?

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Additional comments or suggestions:

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Contact Us

If you have any questions about kindergarten or the registration form please contact the Kindergarten Registration team on (03) 5624 2540 or via email kinder@bawbawshire.vic.gov.au.

Send Notification?

Child_Address

Street Address

Street Address Line 2

CityState

Post Code

program Type

Show Preferences Only

Yes

Transfers

Yes

crm_orgid

Form Test

Yes

Submission Date

Date

Internal Hide

form_name

token

Cutoff date calculator

Cutoff Date

Date

Age as at cutoff

ineligible to apply

Baw Baw Shire Kindergarten Application Form

Kindergarten Preferences

Child Details

Parent Details

Residency

Additional Information About Your Child

Declaration