Register your Interest Chiltern Long Day Care

Chiltern Long Day Care Waitlist
Register Your Interest

If you are interested in your child attending our Long Day Care program we strongly recommend you complete an application form to be added to our waitlist. Should a position become available we will be in contact with you to provide the next steps in our enrolment process.
Your Details
Parent/Guardian name:*

First NameLast Name
Parents CRN
Parent/Guardian Email address:*
Please be aware this email address will be used to send your enrolment forms should you be offered a place.
Preferred contact number:*
Please enter a valid phone number.
Street Address*

Street Address

Street Address Line 2

CityState

Post Code
Have you applied for CCS?

YesNo
Which parent is the CCS Claim linked to?
Your Child's Details
Child's first name:*

First NameLast Name
Child's date of birth:*

DayMonthYear
Date
Child's CRN
Child 2 Details
Child's first name:

First NameLast Name
Child's CRN
Child's date of birth:

DayMonthYear
Date
Child 3 Details
Child's first name:

First NameLast Name
Child's date of birth:

DayMonthYear
Date
Child's CRN
Enrolment Information
How many days do you require?
I'm looking for care from*

DayMonthYear
Date
What days are you seeking care?*

MondayTuesdayWednesdayThursdayFridayWill take any days available
Does your child have and special needs? Please provide information below?
Priority of Access Fact Sheet
Has your child had sibling's attend Chiltern Long Day Care? Please give details below.
Priority of Access

Allocation of available places is made in accordance with the Australian Government's Priority of Access Guidelines and other information gathered from you as part of this waitlist process. Please answer the following questions to ensure we can assess your waitlist accordingly.
Please select any of these that apply*

Aboriginal and Torres Strait IslanderFamily includes a disabled personThe child is at riskParent 1: Care required for workingParent 2: Care required for workingParent 1: Care required for studyParent 2: Care required for studyParent 1: Looking for workParent 2: Looking for workCare required for socialisationSingle parent family
Has your child(children) or a family member had contact with The Orange Door, Child FIRST or Child Protection in the past?*

YesNo
Please note that we have limited places at our service. If we are unable to accommodate your full request would you be interested in part of your request?

YesNo
Casual Daily Standby List
Any positions that are not being utilised on the day will be offered to families on standby after 10am. Would you be interested in going on our daily standby list?

YesNo
Should be Empty:

Chiltern Long Day Care Waitlist

Your Details

Your Child's Details

Child 2 Details

Child 3 Details

Enrolment Information

Priority of Access Fact Sheet

Priority of Access

Casual Daily Standby List