LMPA Kindergarten/PreKindergarten Registration

* Denotes the field is mandatory

Application Information

  • Application Year

  • 2nd Year of Kindergarten

  • Is this a 2nd year of Kindergarten application?
    Yes No

  • Preferences

    Preference options will be shown once you have selected your Registration Type and Application Year above

    Please only select preferences you will be willing to accept.

Child Details

  • Male Female Other
  • Is your child a triplet/quad who is attending in the same year as their siblings? Yes No
  • Is your child a twin who is attending in the same year as their siblings?
    Yes No

Parent/Guardian 1 Information

  • Home Phone

    Business Phone

    Mobile Phone

  • Email addresses entered must match
  • Will the child's family/carer require an interpreter?
    Yes No

Parent/Guardian 2 Information

  • Home Phone

    Business Phone

    Mobile Phone

Priority of Access for Kindergarten

Additional Child Information

  • At Risk/Vulnerable/Out of Home Care

  • Is your child known to Child FIRST or Child Protection Agency? Yes No
  • Is your child in an Out of Home Care arrangement including kinship care? Yes No
  • My child is attending an Early Start enrolment? Yes No

  • Family Services

  • Does your child/family have a case manager / family support worker? Yes No


    Phone

    Mobile

  • Is your child Aboriginal and/or Torres Strait Islander Status

  • Does your child identify as Aboriginal or Torres Strait Islander?

  • Asylum Seeker/Refugee

  • Are you an asylum seeker or refugee?
    Yes No

  • Concession Cards

  • Do you have a current/valid concession card/visa ?
    Yes No

  • Additional needs of the child

  • Has the child been involved in/referred to any development support programs?
    Yes No

  • Medical needs of the child

  • Does the child have any additional needs/diagnosis or medical conditions/allergies?
    Yes No

  • Prior Connection

  • Do you have a prior connection to your 1st Preference by way of Sibilng in the past or PreKindergarten attendance in prior year ?
    Yes No

Other Information

Maternal Child Health Details

  • Maternal & Child Health Details

  • Has the child had their 2 year old Maternal Child Health Key Age and Stage Visit?
    Yes No
  • Has the child had their 3 1/2 year old Maternal Child Health Key Age and Stage Visit?
    Yes No
  • Attended which Maternal & Child Health Centre:

  • Immunisation Details

  • Court Orders

  • Are there any court orders relating to your child?
    Yes No

  • Additional comments to support your application

Documents for Proof

Each document supplied must be in JPG or PDF format and no larger than 2MB in size.

  • Proof of Age:
  • Proof of Immunisation:
  • Proof of Concession Card:
  • Priority Supporting Documentation - Court Order:

Privacy Statement and Agreement

  • Privacy and Confidentiality Statement

  • The personal information requested on this application is collected by the Central Enrolment System (CES) for the provision of central enrolment placement for early childhood education and care services in the region. This information will be used by CES for that primary purpose and/or directly related purposes, e.g. invoicing of fees/ placement and transition of children to kindergarten etc. All information will be treated confidentially. CES may disclose information compiled to relevant Government and Council organizations, Shine Bright EYM, Early Years services and the Bendigo Bank for the purpose of enrolment and kindergarten funding. Additional information gathered about children’s special needs will be used to support the transition process to kindergarten for these children. Information gathered may be used for the purpose of equitable distribution of places across all kindergarten programs.

Credit Card Payment

  • Payment secured by SecurePay

    Registration fee to be paid: $30.00

    Name
    Card Number
    CVV
    Card Expiry

Tick this box if you would like to register this child for Kindergarten after submitting this application.Tick this box if you would like to register another child after submitting this application