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Waiting List Form
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This field is for validation purposes and should be left unchanged.
Child's Information
Child's Name
(Required)
Given Names
Last Name
Address
(Required)
Street Address
Town
State
Postcode
Gender
(Required)
Female
Male
Non-Binary
Date of Birth
(Required)
Kindergarten Start Year
(Required)
(Child will turn 4 by June 30th of this year)
During their Kindergarten year will your child also attend another early childhood program?
(Required)
No
Kindergarten
Child Care Centre
Family Day Care
Other
If your child gains a placement in our Kindergarten program, will you acknowledge this as your only access to a minimum of 15 hours of an Approved Kindergarten Program?
(Required)
(Priority of offer of placement may be given to those families who acknowledge this service as their provider of an Approved Kindergarten Program for 15 hours due to funding eligibility. Please refer to Access and Admissions policy.)
Yes
No
If no, name of other program:
Has your child been diagnosed with additional needs and/or has your child attended any allied health services such as occupational therapist, speech therapist etc?
(Required)
Yes
No
If yes, details:
Additional Comments
Parent/Guardian Information
Parent/Guardian 1
Parent 1 Name
(Required)
First
Last
Parent 1 Email
(Required)
Parent 1 Phone
(Required)
Parent 1 Alternative Phone
Parent 1 Address
(Required)
Street Address
Town
State
Postcode
Parent 1 Date of Birth
(Required)
Parent/Guardian 2
Parent 2 Name
First
Last
Parent 2 Email
Parent 2 Phone
Parent 2 Alternative Phone
Parent 2 Address
Street Address
Town
State
Postcode
Parent 2 Date of Birth
Waiting List Terms
Do you agree to our Waiting List Fee terms
(Required)
I wish to apply to have my child’s name included on the enrolment list for Beerwah and District Kindergarten.
I understand that this does not automatically entitle my child to a place, but will depend on vacancies at the appropriate time. I also understand that it is my responsibility to inform the Director of any changes to the addresses or phone numbers listed below.
Yes, I agree
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