Waiting List Application

Please note: Completing the following form registers your expression of interest in enrolling your child/children into the preschool but does not guarantee a place. We will contact you when a place is available for your child.

Child's Details

First Name *

Last Name *

Sex *
malefemale

Date of Birth *

Residential Address *

Preferred Email *

Parent 1

First Name *

Last Name *

Residential Address

Home Phone Number

Work/Mobile Phone

Parent 2

First Name

Last Name

Residential Address

Home Phone Number

Work/Mobile Phone

General Information

What year do you expect your child to start primary school? *

Does your child identify as

Aboriginal or Torres Strait Islander?Low Income Health Care Card Holder?From a language background other than English?Physical, Intellectual, Developmental or Behavioural disability?At risk of significant harm?

What days would you like your child to attend Preschool? *

MondayTuesdayWednesdayThursdayFridayFlexible

Do you require these particular days because of employment reasons?
---yesno

Will your child require additional assistance at preschool for medical, developmental, or allergic conditions? *
---yesno

If yes, please provide details and names of organisations/therapists that can assist with your child's transition

I give permission for Coffs Harbour Preschool to contact the above named organisation/therapist for the purpose of discussing the needs of my child in relation to attending preschool
---yesno

Name of Consenting Parent

Other Information

Enter code below to complete your Waiting List Application:

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