Central Kindergarten Registration

Application Form for 3 and 4 year old Kindergarten

This form enables you to register your interest to attend kindergarten within the City of Ballarat the year prior to attending school or to attend 3 year old kindergarten two years prior to attending school.

For further information related to Central Kindergarten Registrations and criteria for Priority of Access please refer to the City of Ballarat Central Kindergarten Registration Policy.

This registration applies to these member kindergartens.

Child Details

today Date of Birth
for example: 31 01 2016
DD
MM
YYYY
What is your child's gender?

Is your child a twin or triplet?

Does your child have a disability, developmental delay or complex medical needs?
We encourage you to attend your Maternal and Child Health Key Age and Stage consultations with your child. Has your child had their 2-year-old or 3.5 year old KAS visit (if relevant)?

Do you agree to MCH contacting you to arrange appointments?

Answers to the following questions may mean that your child is eligible for free or subsidised kindergarten

Is your child identified as being of Aboriginal or Torres Strait Islander origin?
Does your child have Refugee or Asylum Seeker status?
Are you a Health Care or Concession Card holder?
Has your child had contact with ChildFIRST or Child Protection?

Parent or Guardian Contact Details

Primary Decision Maker
phone
email
Additional Parent or Guardian (optional) delete
phone
email

Additional Contact Details (optional)

In the event you are unable to be contacted, please give permission to contact:

phone
email

Kindergarten Preferences



3 Year Old Program
Preferences
4 Year Old Program
Preferences

Kindergarten Preferences

Please tick the year you are registering your child for
Date of Birth Attending 3 year old kindergarten in Attending 4 year old kindergarten in
1 May 2015 to 30 April 2016
1 May 2016 to 30 April 2017
1 May 2017 to 30 April 2018
3 Year Old Program
Please list your 3 preferred kindergartens
4 Year Old Program
Please list your 3 preferred kindergartens
How did you find out about the Central Kindergarten Registration scheme?

Privacy Collection Statement

Your personal information is being collected by the City of Ballarat for the purposes of kindergarten allocation. Your information will be stored in the City of Ballarat’s Customer Database and used to identify you when communicating with the City of Ballarat and for the delivery of services and information. For further information on how your personal information is handled, refer to the City of Ballarat’s Privacy Policy at www.ballarat.vic.gov.au