application form

Preschool Application Form

Please complete this application to register your child on our central enrolment system. One application form per child. Complete the online form or download the PDF and send pages 3 & 4 along with $20 Preschool Application Fee. This fee covers the cost of processing your application and is non-refundable.

PAYMENT

Direct Deposit to: Yarra Ranges Kindergartens Inc.
Bendigo Bank BSB 633 000 Acc. 146 421 953
with ‘PAF’ + Parent/Guardian name as reference (eg: PAFSmith)

Visa & Mastercard

We will notify you when we have recorded your application on the waiting list. Incomplete information may result in delayed processing.

Mail: Yarra Ranges Kindergartens Inc.
Mail: PO Box 416 Mooroolbark 3138
Phone: 03 9726 0439
E-mail: enrol@yrkinders.com

Please be sure to complete all Information required as incomplete applications are returned and cannot be processed until complete

DOWNLOAD PDF APPLICATION FORM

ONLINE Application Form

Enrolment Form

per child (optional)

PLEASE COMPLETE A SEPARATE APPLICATION PER CHILD

Attend (optional)

I wish my child to attend (select one or both):

3/4 year old preschool in: (optional)

4/5 year old preschool in: (optional)

Number (optional)

Please select your preferred preschool first then your second, third and forth preferences in order form the drop down lists. We will always offer first choice places if possible. Where vacancies do not exist, a place at the next closest centre may be offered.

Location First Preference Select One

Location Second Preference Select One

Location Third Preference Select One

CHILDS DETAILS (optional)

CHILD'S DETAILS:

Child's First Name:

Child's Legal Surname

Child's Gender

MALE

FEMALE

Child's Date of Birth

Name Child is called (e.g. abbreviation or nickname)

PARENTS DETAILS (optional)

ENROLLING PARENT/GUARDIAN* DETAILS:

Guardians First Name

Guardians Surname

Guardians Relationship to the child

Guardians Contact Phone

Secondary Contact Name (optional)

Secondary Contact Phone (optional)

Home Address

Suburb

Postcode

Postal Address (if different to above) (optional)

Suburb (optional)

Postcode (optional)

Main Language Spoken at Home (if not English): (optional)

All our 4/5yo preschools are approved and funded by the Victorian Department of Education & Training (DET). Our kindergarten programs are carried out under all departmental guidelines and requirements.
Children must be fully immunised for age or hold authorised medical exemption before enrolment can be confirmed. Conscientious objection is not an acceptable reason for exemption from immunisation under No Jab, No Play legislation.

My child is up to date with his/her childhood vaccinations (please choose 1 option):

YES - Immunisation History Statement from Australian Immunisation Register attached below. Please note that Maternal Child & Health book pages are no longer considered acceptable proof of Immunisation Status.

NO - Evidence of commencement of an authorised catch-up program attached below

NO - Copy of doctor’s letter of exemption attached below

Please Attach HERE Immunisation History Statement from Australian Immunisation Register OR Evidence of commencement of an authorised catch-up program OR Copy of doctor’s letter of exemption

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Special subsidies are available to all eligible 3/4yo and 4/5yo children of Aboriginal &/or Torres Strait Islander descent or who are known to Child First or Child Protection.

Have you previously received

Early Start Kindergarten (ESK)

Access to Early Learning (AEL) funding?

NONE

We ask you to provide the following details in order that assessment or inclusion services may be anticipated or additional assistance arranged:

Has your child been identified as of Aboriginal descent?

YES

Has your child been identified as of Torres Strait Islander descent?

YES

Is the enrolled child in your care known to Child First, Child Protection, Integrated Family Services or Services Connect?

YES

Has your child been diagnosed at risk of anaphylaxis?

YES

Does your child have a developmental delay, medical condition, disability or are there special circumstances we need to know about?

YES

If YES, please indicate and include any specialist services currently involved: (optional)

Subsidies (optional)

Subsidies also exist for eligible Health Care and Pensioner Concession card holders as well as holders of Special Entry Visas, parents enrolling triplets and quadruplets. Conditions apply. Please provide a copy of your concession card.

I hold an eligible concession card and intend to claim the 4/5yo Kindergarten Fee Subsidy:

YES - Copy Attached Below

YES - Copy not attached TO BE SUPPLIED

Please attach Copy of Eligible Health Care OR Pensioner Concession Card OR Special Entry Visa (optional)

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Special note (optional)

ALL FAMILIES OF CHILDREN ATTENDING 3/4yo MUST PAY FEES.
3/4yo PROGRAMS RECEIVE NO STATE GOVERNMENT FUNDING SO NO FEE SUBSIDIES ARE AVAILABLE FOR HEALTH CARE, PENSIONER CONCESSION OR SPECIAL ENTRY VISA CARD HOLDERS. EXEMPTIONS EXIST FOR ELIGIBLE APPLICANTS.

I have paid the $20 Preschool Application Fee (PAF) as follows:

Credit Card

Deposit (Electronic or over the counter) * details below

As the Parent/Guardian* named above, I am authorised to apply to enrol this child and do so in accordance with the official policies of Yarra Ranges Kindergartens Inc., copies of which I am entitled to receive upon request. I also agree that all fees and charges relating to the enrolment of this child will be paid and that any overdue fees must be paid before enrolment confirmation. I understand that all information provided in this enrolment application will remain confidential.

NAME

Date

*Relative carers who may not be legal guardians but who are the principal carers of the enrolling child need an Informal Relative Carer’s form.
In certain circumstances, eligible families are exempt from all fees and charges.
Contact us on 03 9726 0439 or enrol@yrkinders.com for more information.