Dalby Beck Street Kindy Waiting List Application Form

Waiting List Application Form
If you would like to apply to enrol your child/ren at Dalby Beck Street Kindergarten, please complete this application form. This waiting list application provides us with information about your child, including any special needs we may need to plan for, parent/guardian contact details, as well as your preferred kindergarten group.
- This form is a waiting list application form only. If you are offered a place, we will ask you to complete an enrolment form to formalise the enrolment for your child.
- Please complete a separate form for each child.
- This form does not guarantee your child a place. Enrolment offers are made in consecutive order based on the date the application is received.
- Enrolment offers are made in term 3 the year before kindy starts. You can either accept or decline the offer of a placement.
CHILD INFORMATION
Name*

First NameSurname
Address
Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Date of Birth*

DayMonthYear
Date
Gender*
Year of Attendance (Child turns 4 by June 30)*
From early February, if vacancies exist, we are able to invite younger children (must be over 3 years old) to attend at the Director's discretion. Would you be interested in your child attending the year prior to their eligible kindy year, should vacancies exist? Enrolment priority is given to eligible kindy aged children first before these offers can be made.*

YesNo
Does your child attend any Specialist Services eg. Speech, OT, ECDP?*

YesNo
Please give details*
Have you applied for a NDIS plan?*

YesNo
Is the NDIS plan:*

ApprovedAwaiting approval
Does your child require extra support for any of the following (diagnosed or undiagnosed)? (Further discussions may be required to decide which days of attendance will best support your child's needs Please provide open and honest details, so we can arrange the approprate support for your child.

ASDAllergies/AnaphylaxisADD/ADHDAsthmaBehaviouralDiabetesDevelopmental DelayEpilepsySensoryVisionProcessingDiet/Food AversionToiletingOther
Please give details:
Preferred Program Attendance:*

Either GroupBilbies (Tues/Wed 8.15am to 3.45pm)Possums (Thur/Fri 8.15am to 3.45pm)
Is there any further information you would like to provide?
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Parent/Guardian First Name*
Parent/Guardian Surname*
Parent/Guardian Date of Birth*

DayMonthYear
Date
Relationship to Child*
Mobile Phone Number*
Email*
example@example.com
Todays Date

DayMonthYear
Date
Please press the submit button to finalise your Waiting List Application. A copy of your form will be emailed to you.

Enrolment offers will be made via email in term 3 the year before kindy starts or when a spot becomes available. Please let us know if your details change by emailing admin@beckstkindy.com.au or phoning us on 4662 3586.
Should be Empty:

Waiting List Application Form

CHILD INFORMATION

PARENT/GUARDIAN INFORMATION