Kogarah City Council Children's Services Waiting List Application
A non-refundable administration fee of $20 is required to be paid prior to child being placed on the waiting list.
All fields mark with an * are required
....
Child's First Name:*
Child's Last Name*
Child's Date of Birth (dd/mm/yyyy)*
Child's Sex*

Male Female
Parent 1
First Name Last Name
Parent 1 Work Phone
Parent 1 Home Phone
Parent 1 Mobile
Parent 1 - Are you currently working?

Yes No
Parent 1 - Are you a Kogarah City Council Employee?

Yes No
Parent 2
First Name Last Name
Parent 2 Work Phone
Parent 2 Home Phone
Parent 2 Mobile
Parent 2 - Are you currently working?

Yes No
Parent 2 - Are you a Kogarah City Council Employee?

Yes No

Home Address*

E-mail*
Cultural Background
Languages Spoken
Languages Spoken
Languages Spoken
Languages Spoken
Religion
Please select what year would you like your child to begin service*
Please select required service*
Please select your session preference*
Does your child currently attend another early childhood service?*

Yes No
If yes, please specify which type (e.g. preschool, long day care, family day care, nanny etc.)
Does your child have any siblings who attend/have attended a Kogarah City Council childcare service?*

Yes No
If yes, name of sibling
Does your child have any special learning needs?*

Yes No
If yes, please tell us about them, to help us plan for optimally meeting your child's needs
Is your child of Aboriginal or Torres Strait Islander descent?*

Yes No
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Should be Empty:

Kogarah City Council Children's Services Waiting List Application

A non-refundable administration fee of $20 is required to be paid prior to child being placed on the waiting list.