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

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

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 the Indigenous Australians who belong to the Guringai language group who lived and are living in the Warringah area.

We acknowledge and respect the values and customs of the traditional owners of this land. We pay our respects to elders past, present and future for they hold the memories, traditions, culture and hope of Indigenous Australians. Aboriginal people have lived here for thousands of years, raising and teaching their children. We extend our hand in friendship as we walk together on this land.
Collaroy Plateau Community Kindergarten Inc
41-43 Hall Avenue, Collaroy Plateau, NSW 2097
Telephone: 02 9982 6167
Fax: 02 8964 1901
Facebook: www.facebook.com/CollaroyPlateauCommunityKindergarten
Email:
Website: www.cpck.com.au
ACNC Registered Charity Tick
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