Application Form

    Child's First Name*

    Child's Surname Name*

    Sex*

    Date Of Birth* (format e.g. 01-Jan-2015)

    Child's Address*

    Suburb*

    Postcode*

    Country of Birth*

    Languages spoken*

    Is your child from Aboriginal or Torres Strait decent?*

    Parent/Guardian' s Name*

    Phone

    Mobile*

    Email Address*

    In order to comply with guidelines determined by the Child Care Section, Department of Community Services, Preschools funding body, and to ensure priority of enrolment on a needs basis, you are requested to supply the following information:

    Two Parent Family

    Sole Parent Family

    As we provide some support for children with additional needs, please state any additional needs your child may have; including allergies, developmental delays, Non-English speaking background etc

    Are there any concerns relating to your child's developmental milestones?

    Please list any support services your child is attending i.e. speech therapy, OT etc

    Does your family hold a Low Income Health Care Card as your family may be eligible for a subsidy*

    How did you hear about us?*

    If Other, please indicate how:

    By filling out this form your child’s name goes on to a waiting list. We recommend that you place your child/ren on waiting lists at other centres to provide you with a choice as there is no guarantee that you will be offered a place at or preschool.

    Year to attend
    (Note: Generally children need to be turning 4 by 31st July in the year of attendance. Children turning 4 after 31st July attend the following year)

    Comments

    After clicking send, please scroll to the bottom of the form to make sure you get the message – Your message was sent successfully. Thanks.’  If you do not, firstly please check you have completed the form correctly, and if so please contact us via phone or email.

    You will receive an email within a few days to confirm that we have received your online Application Form. If you do not receive an email confirmation, please contact us directly via phone or email.

    Collaroy Plateau Community Kindergarten recognises the importance of acknowledging the history of First Nations People. We acknowledge and respect the values and customs of the traditional custodians of the land where our preschool is situated.

    We pay our respects to elders past, present and emerging for they hold the memories, traditions, culture and hope of Indigenous Australians. First Nations people protected songlines for well over 40,000 years, raising and teaching their children and creating the first footprints on Country. We extend our hand in friendship as we now walk together with respect for each other and the common goal of protecting the land and all of her inhabitants.

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    Collaroy Plateau Community Kindergarten Inc
    41-43 Hall Avenue, Collaroy Plateau, NSW 2097
    Telephone: 02 9982 6167
    Facebook: /CollaroyPlateauCommunityKindergarten
    Email:
    Website: www.cpck.com.au
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