Waiting List Application Year Preferred *Please note that under our funding agreement with the NSW State Government, preference must be given to children in their year prior to commencing school. Childs First Name Childs Surname Date of Birth Childs Gender BoyGirl Address Suburb State Post Code Email Address Parent 1 Name Home Phone No Mobile No Work No Parent 2 Name Home Phone No Mobile No Work No Is Your Family From a Non English Speaking Background? YesNo Home Language Nationality Do you Hold a Commonwealth Government Family Health Care Card? YesNo Does Your Child Have Any Additional Needs? YesNo Is your child Aboriginal or Torres Strait Islander? YesNo Does your child attend another service? YesNo Placement days Mon/Tue/WedMon/TueThur/FriWed/Thurs/Fri Comments How did you hear about Lalor Park Preschool? I confirm that I am the parent of the child this application is for. Submission of this form is not a guarantee of a placement for your child. Please contact the Director to arrange a visit to sign the form in person, and therefore activate the application. Until the form is signed it will remain inactive. We will notify you as soon as possible if a place becomes available. Placements are confirmed by October. Unsuccessful applicants will be notified by email only. Please leave this field empty. Please leave this field empty.