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enrolment request

Please fill in the online enrolment request form below to be placed on our waiting list.

Child's Name:
Date of Birth (or anticipated date):
How old will your child be at commencement of attendance:
years      months
Name of person enrolling child:*
Relationship to child:*
Address:
Suburb:
Postcode:
Phone (H):*
Phone (W):
Mobile:*
Email:*

Please select the number of days you require:
5 days       4 days       3 days       2 days       1 day
Please select the days you require:
Monday       Tuesday       Wednesday       Thursday      Friday
What hours of care per day will you generally require:
(Eg. 7am - 3pm)
Has your child attended another centre in the past year?
No       Yes
Does your child have any special needs or care requirements?
No       Yes      If Yes, please explain:
Preferred Start Date:
How did you learn about Essendon Kids?
Yes, I would like to receive news and updates from Essendon Kids Nursery & Kindergarten.

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