Expression of Interest Form

CHILDREN'S DETAILS :

First Name :(*)

Invalid Input

Family Name:(*)

Invalid Input

DOB:(*)

/ / Invalid Input

First Name:

Invalid Input

Family Name:

Invalid Input

DOB

/ / Invalid Input

First Name:

Invalid Input

Family Name:

Invalid Input

DOB:

/ / Invalid Input

PARENT/GUARDIAN DETAILS:

Parent/Guardian 2 must be completed, unless you are a single parent/guardian family

Parent / Guardian Name 1:(*)

Invalid Input

DOB:(*)

/ / Invalid Input

Home Address:(*)

Invalid Input

Work Phone:(*)

Invalid Input

Home Phone:(*)

Invalid Input

Mobile Phone:(*)

Invalid Input

Employer:(*)

Invalid Input

Address:(*)

Invalid Input

Email Address:(*)

Invalid Input

Any additional information you would like to provide

Invalid Input

Parent / Guardian Name 2:

Invalid Input

DOB:

/ / Invalid Input

Home Address:

Invalid Input

Home Phone:

Invalid Input

Mobile Phone:

Invalid Input

Work Phone:

Invalid Input

Employer:

Invalid Input

Address:

Invalid Input

Email Address:

Invalid Input

Any additional information you would like to provide

Invalid Input

PRIORITY OF ACCESS - VACANCIES:

Permanent child care places are allocated to families based on the Australian Government Department of Education and Training Guidelines. As vacancies arise at this child care service priority will be allocated for children who are:

1. at risk of serious abuse or neglect

2. a child of a sole parent who satisfies, or parents who both satisfy, the activity test through paid employment.

This reflects the Australian Government’s intention to help families who are most in need, and support the safety and wellbeing of children at risk in accordance with the Framework for Protecting Australia’s Children 2009—2020.

SELECT SESSION DAYS / TIMES:

Please indicate the days of attendance (AM – 7.00am to 8.55am, PM- 2.55pm to 6.00pm)

FEES:

After School Care $21.00 per session includes afternoon tea,

Before School Care $13.00 including breakfast.

Parent/Guardian Name:(*)

Invalid Input

Requested Start Date:(*)

Invalid Input

Date of application :(*)

Invalid Input

Notes:

Invalid Input

Please Sign(*)

Sign Above

Invalid Input

Expression of Interest Application

Expression of Interest Application

CHILDREN'S DETAILS :

PARENT/GUARDIAN DETAILS:

PRIORITY OF ACCESS - VACANCIES:

SELECT SESSION DAYS / TIMES:

FEES: