SHNC Long Day Care EOI Form

SHNC Childrens Services - Long Day Care Expression of Interest

Surry Hills Neighbourhood Centre (SHNC) offers a quality Long Day Care service in a new, intimate, facility on the top floor of the Surry Hills Library and Community Centre. Opening hours are 8.00am - 4.30pm. Parents and carers are welcome to submit an expression of interest form about enrolling their child or children. Demand for this service is high and by submitting this form you will be automatically added to our waiting list.
Date Form Submitted

MonthDayYear
Your Name

First NameMiddle NameLast Name
Address

Postal Address

Postal Address Line 2

SuburbState

Post Code
Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Work Number

Area CodePhone Number
E-mail
Number of children you wish to register
Full Name
Birth Date

MonthDayYear
Full Name
Birth Date

MonthDayYear
If the child/children have a sibling already enrolled, please enter sibling's name:
What date would you like to start at Long Day Care?

MonthDayYear
What days of the week would you like your child/children to attend?

Monday, Tuesday & WednesdayThursday & Friday5 days per week
Please select one of the following options to assist us with Priority for Allocating Places (as per Australian Government Department of Education)

A single parent who works/studies full-timeA single parent who works/studies part-timeA single parent who is not working/studyingBoth parents work full-timeBoth parents work part-timeOne parent works full-time, the other works part-timeOne parent works full-time, the other not workingAboriginal or Torres Strait Islander familyA child with a disabilityA family whose CCB is 100%Non-English speaking background familyA child in a socially isolated family
Any additional comments or requests?
Thank you for submitting your expression of interest in SHNC Long Day Care. Please phone us should you have any further enquiries: (02) 9331 8409.

Please do not resubmit the same information, one application is adequate.
Should be Empty:

SHNC Childrens Services - Long Day Care Expression of Interest