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Wait List Application Form

Please note.

Completion of the wait list application does not guarantee your child will be offered placement at this centre. Your child will now be placed on the wait list and we will contact you when a vacancy occurs.

‘If you do not receive confirmation that your application has been received within two working days could you please email us at

Thank you for submitting your application.

    Step 1 of 2

    Child's Name:*

    Date of Birth:*

    Parent’s / Guardian’s Name:*

    Parent’s / Guardian’s Address:*

    Contact Email:*

    Contact number (Mobile):*

    Phone (Home):


    2 of 2 - Criteria for Placement:

    Are you*

    Your spouse*

    Which days do you require care?* MonTuesWedThurFri

    Are your days flexible?*
    YesNo

    Has your child been in care before?

    Is your child’s fully vaccinated:* YesNo

    Hours of care required?*

    When do you require your child to commence?

    Does your child have a disability or special need?


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