Contact Us

Elermore Vale Community Preschool and Early Learning Centre Incorporated

Phone: 02 4951 8102

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Join our waiting list, complete the following details

Child's Full Name*

Child's Date of Birth

Day

Month

Year

Parent/ Guardian Full name*

Residential Address *

Phone*

Email*

Relationship to Child*

Days you would like your child to attend

Monday

Tuesday

Wednesday

Thursday

Friday

Please select all that apply

Preferred Start Date

Please indicate when you would like your child to start at our Centre.

Does your child have any Medical and Health needs that we need to be aware of?

Developmental diagnosis

Behavioural concerns

Asthma

Allergies, including anaphylaxis

Other

Please indicate all that apply. IF the condition is not listed, please give details in other

Is there any additional Information that we should be aware of?

Waiting List Agreement

I understand:

The information I have supplied on this form is to the best of my knowledge true and correct. I understand that it is my responsibility to notify the Centre of any changes to the information supplied. Some changes to circumstances may affect my chances of being offered a place.
If my details are found to be incorrect, e.g. phone numbers etc, my application will be relocated to the back of the list.
I will inform Elermore Vale Community Preschool and Early Learning Centre immediately if I no longer need placement to allow staff to contact other families who need placement.
If this application is for an unborn child a placement will not be offered unless Elermore Vale Community Preschool and Early Learning Centre is provided with further details after my child’s birth.
If I refuse placement three or more times my application may be relegated to the back of the waiting list.

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Ph: 02 4951 8102