3 Year Old Kindergarten Application Form

Farm Road 3yo Kindergarten Application Form
Year for application *
Please Note - child must have turned 3 by the 31st of January in the year for which you are applying.
Child's Name *

First Name Last Name
Date of Birth *

Day Month Year
Language spoken at home
Sex of Child *
Parent/Guardian Name 1: *

First Name Last Name
Parent/Guardian Name 2:

First Name Last Name
Address: *

Street Address

Street Address Line 2

City State

Postcode Country
Home Phone No:

Area Code Phone Number
Mobile Phone No: *
E-mail: *
example@example.com
Is your child of Aboriginal or Torres Straight Islander origin?
Has your child any medical condition or allergies that you are aware of? If yes, please specify: NB. As per Kindergarten Parents Victoria Policy, you are obliged to inform the centre if your child is infected with Hepatitis B.
Has your child any medical condition or allergies that you are aware of? NB. As per Early Learning Association Australia Policy, you are obliged to inform the centre if your child is infected with Hepatitis B.
If yes, please specify: *
If other, please state:
Does your child have any additional needs e.g. developmental delays, speech delay etc. If yes please specify.
This form must be accompanied with a $10.00 application fee which is non-refundable to cover administrative costs.

Payment:

Direct Debit:

BSB: 633-000

Account: 133657213

Account Name: Farm Road Pre-School Inc.

Please use year for application, childs surname, and 3yo as a reference

eg: '2016SMITH3yo"

Please note by pressing submit you are declaring all the information you have entered is true and correct.

Please notify the kindergarten of changes to the above information via email or phone (details available via website)
Should be Empty:

Farm Road 3yo Kindergarten Application Form