Expression of Interest Form

CHILDREN'S DETAILS :

First Name :(*)

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Family Name:(*)

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DOB:(*)

/ / Invalid Input

First Name:

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Family Name:

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DOB

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First Name:

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Family Name:

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DOB:

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PARENT/GUARDIAN DETAILS:

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

Parent / Guardian Name 1:(*)

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DOB:(*)

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Home Address:(*)

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Work Phone:(*)

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Home Phone:(*)

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Mobile Phone:(*)

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Employer:(*)

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Address:(*)

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Email Address:(*)

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Any additional information you would like to provide

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Parent / Guardian Name 2:

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DOB:

/ / Invalid Input

Home Address:

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Home Phone:

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Mobile Phone:

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Work Phone:

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Employer:

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Address:

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Email Address:

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Any additional information you would like to provide

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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 $22.00 per session includes afternoon tea,

Before School Care $13.00 including breakfast.

Parent/Guardian Name:(*)

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Requested Start Date:(*)

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Date of application :(*)

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Notes:

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Please Sign(*)

Sign Above

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Expression of Interest Application

Expression of Interest Application

CHILDREN'S DETAILS :

PARENT/GUARDIAN DETAILS:

PRIORITY OF ACCESS - VACANCIES:

SELECT SESSION DAYS / TIMES:

FEES: