Register Your Interest

Family Name:

Child’s First Name:

Date of Birth:

Address:

Attendance requested (Please Tick):
MondayTuesdayWednesdayThursdayFriday

Expected Time of Arrival:

Expected Time of Pick up:

Date Care required from?:

Person registering the interest:
– Please select an option –MotherFatherOther

Date:

Family Name:

First Name:

Address:

Home Number:

Mobile:

Work:

Email:

Best communication method:
LetterEmailIn Person

Priority of Access:

The Australian Government has determined Priority of Access guidelines for long day care centres.
Please tick which applies to you. Please indicate if you or your child relate to any of the following categories:

Aboriginal / TSDisabilityNon-English speaking backgroundSocially isolated familiesSingle parentLow IncomeStudent mother / fatherBoth parents working

Comments: