WAITING LIST APPLICATION
Date of Birth
Main Spoken Language:
Is your child of Aboriginal or Torres Strait Islander origin?
Yes - Aboriginal / Torres Strait Islander
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Trinidad and Tobago
Bosnia and Herzegovina
United Arab Emirates
Papua New Guinea
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Sao Tome and Principe
United Republic of Tanzania
Country / Region
Has your child attended or is currently attending another childcare service?
If Yes: Name of service and number of days:
Do you plan for your child to be involved in Carlingford Kindergarten’s intensive TransiTon to School program the year prior to going to primary school?
If no, how will you prepare your child for primary school?
Anticipate year of school entry:
Name of school:
Start date required:
How many days do you require for your child to attend?
5 days Monday to Friday
3 days Monday/Tuesday/Wednesday
3 days Wednesday/Thursday/Friday
2 days Monday/Tuesday
2 days Thursday/Friday
CONSIDERATIONS OF THE CHILD
Carlingford Kindergarten is committed to providing quality childcare for all children including those with additional needs, allergies and health problems or any other special requirements.
Does your child have any additional needs, or are there any other details relevant to your circumstances?
If yes, please provide details:
SPECIALIST:Is your child seeing any specialist agencies? eg; Speech/Occupational therapists, Dietician etc).
Yes, please provide details:
IMMUNISATION: Is your child's immunisation up to date? (if no, we will not be able to accept your child).
Parent/Guardian 1 - Primary Carer contact details:
Parent/Guardian 2 - Secondary Carer contact details:
Relationship to child:
Relationship to child:
Parent 1 Centrelink CRN:
Parent 1 Centrelink CRN:
Parent 1 Mobile:
Parent 2 Mobile:
Date of Birth of Parent 1 :
Date of Birth of Parent 2:
Do you require any of our service information to be interpreted into your home language?
If yes, which language is required for interpretation?
How did you hear about Carlingford Kindergarten?
If the referral was made by an existing family, what was the families name?
Name/s of siblings currently in care or previously attended (if applicable):
CHILD CARE SUBSIDY (CCS)
Under the Child Care Subsidy System, (CCSS), a family’s subsidy percentage is determined by the family’s combined annual income, and the number of subsidised hours per fortnight is calculated according to hours of recognised activity under the New Activity Test.
Have you undertaken your
assessment for Child Care
If YES, how many subsidised hours per fortnight are you eligible for?
If NO, please ensure you are assessed for your family’s CCS entitlement ASAP.
PRIORITY OF ACCESS
Carlingford Kindergarten complies with the Enrolment Priority / Access Guidelines as set by the Department of Social Services for Centre Based Long Day Care Service. (please Tck)
Priority 1: a child at risk of serious abuse or neglect
Priority 2: a child of a parent who satisfies, or of parents who both satisfy, the work/training/study test under Section 14 of the A New Tax System (Family Assistance) Act 1999 (see notes below)
Priority 3: Child of current siblings attending or past attending siblings
Priority 4: any other child on the waitlist- (Date on Application)
Notes for Priority 2:
An individual is recognised to be in work or work related commitments if they:
• Are in paid work (for at least 15 hours per week)
• Receive a carer payment under Part 2.5 of the Social Security Act 1991, or
• Receive a carer allowance for a disable adult as per section 952 of the Social Security Act 1991
An individual has recognised training commitments if undertaking a training course (for at least 15 hours per week) for the purpose of improving work skills and/or employment prospects, including during course vacations.
An individual has recognised study commitments if:
• Receiving a youth allowance and undertaking full-Tme study (at least 15 hours per week)
• Receiving Austudy payment under the Social Security Act 1991
• Receiving a pensioner education supplement under the Social Security Act 1991
• Receiving assistance under the ABSTUDY scheme, or
• Undertaking any other education course (for at least 15 hours per week) for the purpose of improving work skills and/or employment prospects, including during course vacations.
Source: Sections 14-17A of ‘A New Tax System (Family Assistance) Act 1999’
Acknowledgement of waiting list application
I understand that I may not be able to commence care by the date from which care is required.
I understand the priority is given to families with greatest need.
I agree to notify Carlingford Kindergarten in order to remove my child from the waitng list. Your child will automatcally be removed from the waitng list once they atend primary school (based on antcipated year of school entry date completed on this
Your child will automatically be removed from the waiting list once they attend primary school (based on anticipated year of school entry date completed on this form).
I agree to contact Carlingford Kindergarten to update any of the above details should they change.
understand that a NON-REFUNABLE WAITING LIST FEE OF $20 applies to my Waitng List Applicaton and that my child’s place on the waitng list will not be confirmed untl payment is made to the following account, Account Name: Carlingford Kindergarten:
Account Name: Carlingford Kindergarten BSB 484 799 Account No. 204 220 331
I understand this form is an applicaton to be placed on the waitng list for enrolments. It does not guarantee a place, nor the days requested, as these decisions will be based on priorites to be implemented by the Nominated Supervisor of the Service.
Name of person completing this Form:
Thank you – we will contact you as soon as a position becomes available in line with your request
OFFICE USE ONLY
Date applications Received:
$20 Waiting list Deposit Paid:
Copy of Australian Immunisation Record provided (if No, your application will be unable to be processed)