Pre-school Enrolment Form
Submission Date
-
Day
-
Month
Year
Date
Renewal Date
-
Day
-
Month
Year
Date
Are you already a RICE Member? This is a requirement to join our pre-school Program.
*
Yes
No
Contact Name
*
First Name
Last Name
Contact Email
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: 0000000000.
Postal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address
*
Same as postal address
Different address
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Day
-
Month
Year
Date
Add another child to RICE Membership?
*
Yes
No
Will this child also be enrolled in pre-school?
*
Yes
No
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Day
-
Month
Year
Date
Add another child?
*
Yes
No
Will this child also be enrolled in pre-school?
*
Yes
No
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Day
-
Month
Year
Date
Add another child to RICE Membership?
*
Yes
No
Will this child also be enrolled in pre-school?
*
Yes
No
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Day
-
Month
Year
Date
Secondary Account Contact Name
*
First Name
Last Name
Secondary Account Contact Email
*
example@example.com
Secondary Account Contact Phone Number
*
Please enter a valid phone number.
Format: 0000000000.
Other Interests
*
Wellbeing Program
Outback Childcare
Activity Days
Remote Creche
Playdays
Total cost
Processing Fee
Total cost + fee
Enrolment Fee
*
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( X )
AUD
This is the total fee for your family membership (if not already a member) and the pre-school fee for each child. Includes Processing Fee.
Proceed to payment
Should be Empty: