Campaspe Shire Council

Campaspe Shire Council

Kindergarten Central Registration Application
This application is the first step in registering your child for kindergarten. It does not guarantee a placement. Applications are prioritised by applying state government and local priority of access criteria.

Further information can be found in the 2027 Campaspe Shire Kindergarten Guidelines on Council's website.
What year would you like your child to commence kindergarten? *
What year would you like your child to commence kindergarten? *
Mapped Care Period*
What program type is this application relevant to?*
Deferral Form

YesNo
Form test

Yes
Flag
crm_orgid
Child's Details
Child's Name*

First NameLast Name
Gender*

MaleFemaleUnspecified
Child's Date of Birth*

DayMonthYear
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.
Child's Residential Address*

Street Address

Street Address Line 2

TownState

Post Code
Child's Living Arrangement*

Both parentsParent / Primary Carer 1Parent / Primary Carer 2Formal Kinship CareFoster CarePermanent CareResidential CareInformal Kinship Care
Primary language spoken at home
Was this child born in Australia?*

YesNo
- Country of Birth
- What country was this child born in?*
- What year did the child arrive in Australia?*
- Parent / Carer Details
- Parent / Primary Carer 1*
  
  First NameLast Name
- Relationship to the child*
- Residential Address*
  
  Street Address
  
  Street Address Line 2
  
  TownState
  
  Post Code
- Phone Number*
  Mobile preferred
- Email*
  Please Note: You will be notified of all correspondence via email
- Does Parent / Primary Carer 1 hold a Commonwealth Health Care Card?*
  
  YesNo
- Health Care Number*
- Health Care Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Health Care card*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 1 hold a Commonwealth Pensioner Concession Card?*
  
  YesNo
- Pensioner Number*
- Pensioner Card Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Pensioner Concession card*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 1 hold a Veterans Affairs Card?*
  
  YesNo
- Department of Veterans Affairs Number*
- Department of Veterans Affairs Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Department of Veterans Affairs card*
  
  Browse Files
  
  Cancelof
- Is parent / primary carer 1 eligible under the NDIS or undergoing an assessment of a disability under the NDIS (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*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 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*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 1 require an interpreter?*
  
  YesNo
- Was Parent / Primary Carer 1 born in Australia?*
  
  YesNo
- Country of Birth
- Parent / Primary Carer 1 country of birth*
- What year did the Parent / Primary Carer 1 arrive in Australia?*
- Parent/Career education and occupation data
  
  Kindergarten services must collect the occupation and education details from the parents/carers of all children enrolling in a funded kindergarten program. These details determine the amount of additional funding that individual kindergarten services will receive. Please see here for more details of the occupations within each group. If the person has not been in paid work for the last 12 months, select ‘N’. If the person has had a job or retired within the last 12 months, please choose the most recent occupation group.
- What is the highest year of school that Parent / Primary Carer 1 has completed?*
- What is the level of the highest qualification that Parent / Primary Carer 1 has completed?*
- What is the occupation of Parent / Primary Carer 1?*
- What is the occupation group of Parent / Primary Carer 1?*
- Would you like to add a second Parent / Primary Carer?*
  
  YesNo
- Parent / Primary Carer 2*
  
  First NameLast Name
- Relationship to the child*
- Parent / Primary Carer 2 Address*
  
  Same as parent / Primary Carer 1Different to parent / Primary Carer 1
- Residential Address*
  
  Street Address
  
  Street Address Line 2
  
  TownState
  
  Post Code
- Phone Number
  Mobile preferred
- Email*
  Please Note: You will be notified of all correspondence via email
- Does Parent / Primary Carer 2 hold a Commonwealth Health Care Card?
  
  YesNo
- Health Care Number*
- Health Care Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Health Care card*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 2 hold a Commonwealth Pensioner Concession Card?
  
  YesNo
- Pensioner Number*
- Pensioner Number*
- Pensioner Card Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Pensioner Concession card*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 2 hold a Veterans Affairs Card?
  
  YesNo
- Department of Veterans Affairs Number*
- Department of Veterans Affairs Expiry Date*
  
  DayMonthYear
- Please attach a copy of your Department of Veterans Affairs card*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 2 have a NDIS number or are they undergoing assessment for disability under the NDIS currently?*
  
  YesNo
- Please provide further details*
  
  0/230
- Please attach a copy of the assessment or letter*
  
  Browse Files
  
  Cancelof
- Does Parent / Primary Carer 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*
  
  Browse Files
  
  Cancelof
- Was Parent / Primary Carer 2 born in Australia?*
  
  YesNo
- Country of Birth
- Parent / Primary Carer 2 country of birth*
- What year did the Parent / Primary Carer 2 arrive in Australia?*
- What is the highest year of school that Parent / Primary Carer 2 has completed?*
- What is the level of the highest qualification that Parent / Primary Carer 2 has completed?*
- What is the occupation of Parent / Primary Carer 2?*
- What is the occupation group of Parent / Primary Carer 2?*
- Additional information about your child
- By completing the following information, you will help our team support your family. This information will also be used to determine priority of access for a kindergarten placement and access to additional hours for priority cohorts (as defined by the Department of Education)
- Is this child Aboriginal or Torres Strait Islander?*
  
  NoTorres Strait IslanderAboriginalBoth Aboriginal and Torres Strait Islander
- Does your child hold a Commonwealth or Disability Health Care Card?*
  
  YesNo
- Health Care Number*
- Health Care expiry date*
  
  DayMonthYear
- Please attach a copy of the Health Care card*
  
  Browse Files
  
  Cancelof
- Please select if you or your child have ever held or are applying for one of the following VISA’s:
  
  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)Bridging visa A-E for humanitarian or refugee visaHumanitarian Stay visa (subclass 449)Temporary Protection visa (subclass 785)Safe Haven Enterprise visa (subclass 790)Current or expired ImmiCard
- Please note: The eligibility of concessions may vary from time-to-time. Up-to-date information can be found here.
- Please attach a copy of your visa*
  
  Browse Files
  Max 10MB total file size Cancelof
- 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 or Child and Family Services
- Do any of the above apply to you, your child, or your family?*
  
  YesNo
- If yes, please select from the following:*
  
  Experiencing family violence or has had contact with The Orange DoorKnown to or had contact with Child Protection or in Out-of-Home-CareChild or family previously accessed Flexible Support PackagesReferred by Child Protection, Child and Family services, MCH nurse, Out of Home Care provider
- Do any of the following apply to your child?
  
  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 request
- 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 support letter / referral 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.
- *
  
  Browse Files
  
  Cancelof
- Is this child a multiple birth (triplet or quadruplet or more)?*
  
  YesNo
- 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.
- Is your child’s current kindergarten applying for a second year of funded {servicevicepreference_program-type}?
  
  YesNo
- 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.
- P1 eligible?
- P2 eligible?
- input_PPPC
- Pre Prep Priority Cohort
- Health Information
- Has your child been immunised and is the schedule up to date? *
  
  YesNo
- I acknowledge that being offered a place through central registration is not a confirmed enrolment into kindergarten. Per the No Jab No Play policy, children must be fully vaccinated to go to kindergarten.*
  
  Acknowledged
- If your child is not up to date with their immunisations and not eligible for the support period, your enrolment may be compromised. You will be asked again to provide your child’s Immunisation History Statement when they enrol at kindergarten. If your child is not up to date, please contact Council’s immunisation team Ph 1300 666 535, your doctor or Maternal and Child Health nurse for support and to organise your child’s immunisations before kindergarten starts.
- Please attach your child's immunisation record*
  
  Browse Files
  
  Cancelof
- Under the ‘No Jab, No Play’ legislation, before enrolling a child, early childhood education and care services have to first obtain evidence that the child is up to date with all vaccinations that are due for their age, or that they are able to receive.
  
  An Immunisation History Statement from the Australian Immunisation Register (AIR) is the only form of documentation accepted for the purpose of enrolling in an early childhood education and care service.
  
  After enrolment, parents will need to continue to provide up to date Immunisation History Statements to their child’s early childhood service, if their status changes.
  
  You can get your immunisation history statement straight away by accessing your medicare online account via my.gov.au
  
  If you can't use Medicare online, we can print your immunisation history statement for you.
  
  You can also call the AIR enquiries line (1800 653 809) and ask them to send your immunisation history statement to you. It can take up to 14 days to arrive in the post.
  
  Please note: Only Immunisation History Statements from the Australian Immunisation Register will be accepted as evidence of immunisation.
- Does your child have allergies or other medical conditions eg asthma/epilepsy?*
  
  YesNo
- Please provide details (allergies and treatment)*
  
  0/255
- Has your child had their two or three-and-a half-year old Maternal & Child Health visit?*
  
  YesNo
- Are you registering another child for the same year?*
  
  YesNo
- Name of other child?*
  
  0/220
- Kindergarten Preferences
- Based on your responses, your child is eligible to attend between 16 and 22.5 hours of Pre-Prep kindergarten per week. You have a choice about whether you would like your child to attend 15 hours per week of Four-Year-Old kindergarten or additional hours through PrePrep.
- 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 3 preferences. Only select preferences you are willing to consider.
  
  Preferences can be listed across one service or multiple services.
  
  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:
  - All information provided by me is true and correct
  - All information provided by me may be audited at any time. This registration or subsequent kindergarten allocation could be reallocated or withdrawn if the information is incorrect
  - Failure to provide complete and correct information may result in the registration being excluded from the allocation process
  - This is a registration form and does not guarantee a three or four-year-old kindergarten placement
  - Three and four-year-old kindergarten places are allocated separately.
  - Every effort will be made to place my child at the same service for four-year-old kindergarten. However, there is no guarantee of this.
  - I can be contacted by Council from time to time with information regarding relevant events, issues and services
  - To participate in the Central Registration Scheme my personal information will be shared securely with the preferred kindergarten service provider nominated by me on this or subsequent forms
- Collection Notice
  
  The personal and health information collected by Campaspe Shire Council is used to coordinate the Campaspe Shire Kindergarten Central Registration Scheme. The information provided will be used solely for this purpose, or any other directly related purpose and will be collected, stored, and disclosed in line with the Privacy and Data Protection Act 2014 (Vic) and the Health Records Act 2001. The information may be shared with other organisations and government agencies with your consent, or where required by law.
  
  If you wish to access or alter any of the personal and health information you have provided, please contact Council on 1300 666 535 or shire@campaspe.vic.gov.au. For further information on how we manage your information please refer to Council’s Privacy and Data Protection Policy at www.campaspe.vic.gov.au.
- Already Paid?
  
  Yes
- Send Notification?
- internal_hide
  
  Yes
- update_preferences
- show_preferences_only
  
  Yes
- Current Date
  
  DayMonthYear
  Date
- form_name
- Offer_Response
- Program Type Input
- NA 16APR25 REMOVED - Has your child or an older sibling attended the service of your first preference in the last 5 years?
  
  YesNo
- Child/Sibling Name
  eg. Billie Smith
- Year
- Child/Sibling Name
  eg. Billie Smith
- Year
- Cutoff date calculator
- Cutoff Date
  
  DayMonthYear
  Date
- Age as at cutoff
- ineligible to apply
- Should be Empty:

Child's Details

Parent / Carer Details

Additional information about your child

Health Information

Kindergarten Preferences

Authorisation and Declaration