Phone: 07 3374 0689

Excellence in Early Childhood Education

 
 
 
  

Waiting List Form

Child Details

Child’s Name (*)
Please let us know your name.
DOB (*) / /
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Gender of Child (*)
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Parent/Guardian 1 Details

Parent/Guardian Name (*)
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Relationship to the Child (*)
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Address (*)
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Telephone (*)
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Mobile (*)
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Email Address (*)
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Parent/Guardian 2 Details

Parent/Guardian Name (*)
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Relationship to the Child (*)
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Address (*)
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Telephone (*)
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Mobile (*)
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Email Address (*)
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Under Childcare Assistance Australian Guidelines, it must be stated whether both parents are either (*)
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(Please indicate the category into which you fall. If one or both parents are working, please indicate your place of employment below.)
Guardian/ Parent 1 – Workplace (*)
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Guardian/Parent 2 – Workplace
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Work Phone (*)
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Work Phone
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Details of Days Required

Date of Proposed Commencement (*)
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Will you accept placement
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Preferred Days of Attendance (*)
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Number of Days Required (*)
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Are these days flexible? (*)
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Commonwealth Government Guidelines for Priority of Access

All applications for enrolment are considered equally. We do not discriminate against any person who applies to enrol their child or children at the Brookfield Early Childhood Centre. However, should the service be operating at maximum capacity, we are obligated to comply with these guidelines and access must be prioritised according to the following criteria. Please choose which one best describes your family situation. (*)



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Within these main Priority categories, priority should also be given to children with family that might meet one of the following priorities. Please tick any extra priorities your family might meet (*)







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