four year old kindergarten enrolment form - Banyule City Council

FOUR YEAR KINDERGARTENENROLMENT APPLICATION FORMI wish to register my child toattend 4 year old kindergarten in:(please tick)Date of birth range:(children must turn 4 years of age by 30 April of year ofattendance at 4 year old kindergarten)Applications open: 2014 1 January 2009 – 30 April 2010 1 March 2012 2015 1 January 2010 – 30 April 2011 1 March 2013 2016 1 January 2011 – 30 April 2012 1 March 2014Four year old Kindergarten enrolment fee:$30.00 non-refundable processing feeororHealth Care/Concession Card holders – no fee(Photocopy of Health Care/Concession Card attached Yes)Families enrolling triplets or quadruplets – no fee(Each child would need to be enrolled separately)OFFICE USE ONLY:T161 44390.21.6789Child NAR:Parent/Guardian NAR:Application Number:NOTE: Register separately with your local kindergarten for attendance at a 3 year oldkindergarten program. Please refer to the list of kindergartens within Banyule on page 3.CHILD’S DETAILS: (BLOCK LETTERS PLEASE)Surname: _________________________ Given Names: _______________ _______________Date of Birth: ____/____/____ Male or Female (please circle)NOTE: Photocopy of birth certificate or passport must be attachedDoes your child identify as Aboriginal or Torres Strait Islander Yes NoADDITIONAL NEEDS/REQUIREMENTS:Does your child have any additional needs/requirements? Yes NoComments: ___________________________________________________________________________________________________________________________________PARENT/GUARDIAN DETAILS:Mr/Mrs/Ms: Surname: ______________________Given Names: ___________ _____________Date of Birth ___/___/___ Address: _________________________________________________________________________________________ Postcode_____________Telephone: (H) ________________ (Mob) ___________________ (W) ____________________Email Address: ______________________________________________Do you give permission for Council to contact you via email? Yes NoI acknowledge that my name and contact details will be shared by Council for the purposes ofCentral Kindergartens Enrolments. Initial: ______Children’s Services 09664 Enrolment Form InfoVision Ref:OptionalLast Amended:22/01/2014Page 1 of 4

KINDERGARTEN PREFERENCES:Please list in order of preference only those kindergartens at which you would be willing toaccept a place. We encourage you to visit your local kindergartens to ensure that the program,fees and hours etc. are suitable. #1. ______________________________________2. ______________________________________3. ______________________________________# please note that Rosanna Uniting Preschool will cease operation on 19 December 2014.BANYULE CITY COUNCIL NON-RESIDENTS:If you do not live in Banyule please indicate your reason for enrolling.Use home based childcare (e.g. Family Day Care) Details: ______________________________________________________________________________________________I work in the Banyule MunicipalityDetails: ________________________________________________The first preference listed is the closest kindergarten to my homeOther __________________________________________________________________Council respects all personal and confidential information you give and will do everything possible toprotect information from unauthorised access, loss or misuse. Information collected from you is requiredfor the delivery of Council Services in accordance with Council’s powers, functions and purposes under theLocal Government Act 1989 and other relevant legislation. It may also be used by Council to conductresearch and customer satisfaction surveys so that we may better understand community needs and canimprove service delivery. Should you need to change or access your personal details, please contactCouncil on 9490 4222.I ___________________________________ (please print your name) understand that the informationprovided above will be used in accordance with relevant legislation and declare that this information iscorrect to the best of my knowledge.Signature: ______________________________________________ Date: _________________PORTANT Take the form and a photocopy of proof of age such as birth certificate or passport to anyone of Council’s Service Centres. Council has EFTPOS facilities at these centres; cash,cheque and money orders are also accepted.Rosanna: 44 Turnham AvenueIvanhoe: 275 Upper Heidelberg RoadGreensborough: 9 - 13 Flintoff StreetORPost to Kindergarten Enrolment Officer,PO Box 51Ivanhoe VIC 3079.Please attach your cheque or money order for $30.00 non-refundable Kindergartenenrolment fee (payable to Banyule City Council) and a photocopy of proof of age such as abirth certificate or passport.NOTE: No Kindergarten enrolment fee charged to Health Care/Concession card holders orfamilies who are enrolling triplets or quadruplets.Children’s Services 09664 Enrolment Form InfoVision Ref:OptionalLast Amended:22/01/2014Page 2 of 4

Kindergarten Address Phone MelwayNumber ReferenceApollo Parkways Preschool* 31 Plenty River Drive, Greensborough 9435 8752 Map 10 K12Audrey Brooks Preschool 347 Bell St, Heidelberg West 9459 1931 Map 31 E3Briar Hill Preschool* 118 Karingal Drive, Briar Hill 9435 2734 Map 21 E2Bundoora Preschool* 20 Noorong Ave, Bundoora 9467 5343 Map 19 K2Delta Road Preschool* 15 Delta Rd, Watsonia 9434 1113 Map 20 G5East Ivanhoe Preschool* 1 King Street, East Ivanhoe 9499 6493 Map 31 K8Fairy Hills Preschool* 7 Thyer Rd, Ivanhoe 9499 5429 Map 31 E10Grace Park Preschool* 179 Nepean Street, Greensborough 9435 6179 Map 20 J4Greenhills Preschool* Community Drive, Greensborough 9434 3379 Map 21 B1Greensborough Preschool* 17 – 19 Ester St, Greensborough 9434 4645 Map 20 H2Heidelberg Preschool* Orient Place, Heidelberg 9457 2492 Map 31 K4Interlaken Preschool* 19 Interlaken Parade, Rosanna 9458 1148 Map 20 C11Ivanhoe Uniting Preschool* Seddon Street, Ivanhoe 9499 5797 Map 31 F8Lower Plenty Preschool* 1 Para Road, Lower Plenty 9434 6490 Map 21 A8Macleod Preschool* Birdwood Avenue, Macleod 9457 6284 Map 20 B8Olympic Village Preschool 29 Alamein Road, Heidelberg West 9459 9195 Map 19 E11Panorama Heights Preschool* 3 Mitchell Avenue, Montmorency 9439 7014 Map 21 E8Rosanna Uniting Preschool*# 23 Bellevue Avenue, Rosanna 9458 1060 Map 19 K12Sherbourne Preschool* 156 Sherbourne Rd, Montmorency 9439 2992 Map 21 F4St Andrews Preschool*Cnr. Rattray & Mountainview Rds.,Montmorency9435 6946Map 21 D6St Helena Preschool* 22-28 Wallowa Rd, Eltham North 9438 4140 Map 11 G9Viewbank Preschool* Cnr. Lyon Rd & Duff Parade, Viewbank 9459 2627 Map 20 F10Wahroonga Preschool* 66 Wahroonga Crescent, Greensborough 9434 6089 Map 11 D11Warrawee Park Preschool* 10 The Rameo, Bundoora 9467 4446 Map 10 B12Watsonia North Preschool* 68 Macorna Street, Watsonia 9434 1998 Map 10 E12Watsonia Preschool* 19 Crellin Crescent, Watsonia 9434 4767 Map 20 E3Winston Hills Preschool* 24 Rohan Street, Viewbank 9459 7593 Map 20G12Yallambie Park Preschool* 311 Yallambie Road, Yallambie 9435 9469 Map 20 J8Yandell Preschool* Community Drive, Greensborough 9435 9472 Map 21 B1* These Kindergartens also offer 3 year old kindergarten programs; contact them directly for enrolment information.# Rosanna Uniting Preschool will cease operation on 19 December 2014.NOTE: Long Day Care Centres may also offer 4 year old kindergarten programs, contact the centres directly forenrolment and program related enquiries.Children’s Services 09664 Enrolment Form InfoVision Ref:OptionalLast Amended:23/01/2012Page 3 of 4

Children’s Services 09664 Enrolment Form InfoVision Ref:OptionalLast Amended:23/01/2012Page 4 of 4