Waiting List Application

All children are required to have up to date immunisations. By completing this form you are agreeing to provide an up to date immunisation record prior to enrolment.
Waiting List Policy (Click this link to view)
By completing this form you are confirming you have read this Waiting List Policy. (It is a requirement this is read prior to the submission of ALL applications)
Child's Name*
First Last
Date of Birth*
Date Format: DD slash MM slash YYYY
Gender*
- Male
- Female
Address*
Street Address
What school are you considering for your child to attend?*
Does your child have any health problems, developmental delays or disability? (Or family history of)*
Is your family?*
- Aboriginal or Torres Strait Islander background?
- Non-English speaking background?
- Low Income Health Care Card
- Non of the above
please check box if answer is yes
PARENTS DETAILS
Parent/Gaurdian 1 (Primary Contact for position)*
First Last
Parent/Gaurdian 2*
First Last
Mobile Phone Number (Primary Contact)*
Primary Email Contact*
Enter Email Confirm Email
Birth Certificate
Accepted file types: jpg, pdf, png, jpeg, gif, bmp.
To confirm your waiting list application we need a copy (photo or scanned) of the child's birth certificate. (Due to problems uploading and file sizes, you can now email the birth certificate if you are having trouble attaching) PLEASE NOTE: WAITING LIST APPLICATIONS WILL NOT BE ELIGIBLE UNTIL THE BIRTH CERTIFICATE IS RECEIVED. mail@lennoxheadcommunitypreschool.com.au

All children are required to have up to date immunisations. By completing this form you are agreeing to provide an up to date immunisation record prior to enrolment.