Child Details First Name (required) Last Name (required) Service required (required) 3 y.o. sessional kindergarten4 y.o. sessional kindergarten Date of Birth (required) Gender (required) MaleFemale Does your child have a sibling currently enrolled at Poets Grove (long day care or sessional kindergarten)? YesNo Have you previously had a child enrolled at Poets Grove (long day care or sessional kindergarten)? YesNo Primary Parent/Guardian Details Primary Guardian/Parent’s First Name (required) Primary Guardian/Parent’s Last Name (required) Address (required) Suburb (required) Postcode (required) Phone (AH) Phone (BH) Mobile (required) Email (required) Secondary Parent/Guardian Details Secondary Guardian/Parent’s First Name Primary Guardian/Parent’s Last Name Is the address the same as the Primary Parent/Guardian YesNo If no, please fill in your address details below. Address Suburb Postcode Phone (AH) Phone (BH) Mobile Email Additional Information Home language(s) spoken Priority of access criteria for funded kindergarten (as outlined in kindergarten funding guide) – please indicate if any of the following apply: The child is Aboriginal and/or Torres Strait Islander YesNo The child is known to Child Protection YesNo The child is currently attending a 3 year kindergarten program through “Early Start Kindergarten” YesNo The child or the child’s parents are refugees or asylum seekers YesNo The child or the child’s parent holds a Commonwealth Health Care Card, Pensioner Concession Card or Veteran’s Affairs Card YesNo Multiple birth children (triplets, quadruplets) YesNo The child holds a Child Disability Health Care Card YesNo The child has an identified specific disability or developmental delay YesNo Comments
