Childrens House Waiting List Application Form

Brunswick Montessori Children's House Waiting List Application Form
This application is for your child to be placed on the waiting list for Brunswick Montessori Children’s House Inc (Children’s House). Lodgement of this form does not guarantee your child a place at Children’s House.

Before you complete the form please ensure you have read the Enrolment Information Pack that is available from Children’s House. You can request this by emailing info@bmch.org.au

A separate waiting list application form is required for each child.

Please note: This application is for the Children's House kindergarten programme only. There is a separate application form for the Casa Piccola (Little House) Playgroup.

Privacy information: Brunswick Montessori Children's House Inc collects information for administration purposes only and no information will be disclosed to any other party except as required by law.
Family Information
The person completing this form is considered the primary contact for the Child and Children’s House will use this information to inform you of an ‘Offer of Place’

Please note: It is the responsibility of the parent/guardian to ensure Children’s House has current contact details.
Full Name *

First Name Last Name
Relationship to the child *

Mother Father Guardian
Home phone *
Mobile phone *
Work phone
E-mail *

Confirmation Email
Address *

Street Address

Street Address Line 2

City State

Post Code Country
Mailing address (if different to home address)

Street Address

Street Address Line 2

City State

Post Code Country
Child Information
Full Name *

First names Last Name
Gender *

Male Female
Birth Date *

Month Day Year
Address (if different to home address provided above)

Street Address

Street Address Line 2

City State

Post code Country
Place of birth *
Language(s) spoken at home *
Is an interpreter required? *

Yes No
Year of commencement. Please note children start as close to their third birthday as possible - a child born in July 2020 would start July 2023. *

2023 2024 2025
How did you find Children's House?

Montessori Australia Foundation (MAF) website Children's House website Internet search Word of mouth
Children with additional needs
Children’s House is committed to providing quality education for all children including those with additional needs, allergies, health problems or any other special requirements. Does your child have any additional needs, or are there any other details relevant to your application? *

Yes No
If yes, please provide details:
Waiting List Fee
This form needs to be accompanied by payment of the $100 waiting list fee ($75 each additional child) before your child(ren) can be placed on the waiting list. This is an administrative fee and cannot be refunded.

A separate waiting list application form is required for each child.

Please use your child's full name in the account description, so we can keep track of your payment and issue a receipt.

Payment details
Account Name: Brunswick Montessori Children's House Inc.
Bank: Bendigo Community Bank Strathmore
Account No: 147 013 122
Account BSB: 633 000
Checklist
I have received, read and understood the Enrolment Information Pack *

Yes
The Waiting List Fee has been/will be paid to Children's House *

Yes
Should be Empty:

Brunswick Montessori Children's House Waiting List Application Form

Family Information

Child Information

Children with additional needs

Waiting List Fee

Checklist