Enrolment Waitlist Form

:: CHILD'S DETAILS
Child's First Name:
Child's Last Name:
Child's Gender:: FemaleMaleNon-binary/unspecified
Date of Birth:
Home Address:: House/Unit number and street name
Suburb:
State:
Postcode:
Any Additional Needs?:
:: PARENT'S DETAILS
:: Parent / Guardian 1:
Relationship to Child:
Parent's Name:: First Name:

Last Name:
Home Phone:
Mobile Phone:
Work Phone:
Email Address:
:: Parent / Guardian 2:
Relationship to Child:
Parent's Name:: First Name:

Last Name:
Home Phone:
Mobile Phone:
Work Phone:
Email Address:
:: PROGRAM
Kindergarten Program | Year of Commencement (please tick according to your child's birth date):: 2021 (Children born 1st July 2016 - 30th June 2017)2022 (Children born 1st July 2017 - 30th June 2018)2023 (Children born 1st July 2018 - 30th June 2019)2024 (Children born 1st July 2019 - 30th June 2020)2025 (Children born 1st July 2020 - 30th June 2021)2026 (Children born 1st July 2021 - 30th June 2022)
Kindergarten Program Preference (please tick):: 5 day fortnight (6 hours per day)4 day fortnight (7.5 hours per day)4 day fortnight including after-hours care program (10 hours per day)

Harty St uses information from this waitlist form for planning purposes only; parents are required to provide preferences again at the time of enrolment offers in the year before commencement
Pre-Kindergarten Program | Year of Commencement (please tick if applicable):: 2022 (Children born 1st July 2018 to 31st January 2019)2023 (Children born 1st July 2019 to 31st January 2020)2024 (Children born 1st July 2020 - 31 January 2021)

If you are interested in this pre-kindergarten program, please select the year prior to your child's kindergarten year ONLY if their birth date is between 1 July and 31 January.
How did you hear about us?:: Google searchWord of mouthPrevious children have attendedFacebookOther
Other Option:
$10 Waitlist Fee:: CashDeposit via Internet Banking (BSB 064-107 Acc. No. 0005 0022 Commonwealth Bank)
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ENROLMENT WAITLIST

Enrolment Waitlist Form

CHILD'S DETAILS

PARENT'S DETAILS

Parent / Guardian 1:

Parent / Guardian 2:

PROGRAM

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