Register your child

MARGARET IVES CHILDREN’S CENTRE INC
APPLICATION – CHILDCARE WAITING LIST

The completion of this form helps us to respond to your request for childcare placement. We recommend a minimum of 2 days.

You are encouraged to discuss any aspect of the form with the
Director of the Centre and please take a look at the Parent Handbook which provides details about the Centre and its policies.

Mandatory fields are preceded by an asterisk (*)

CHILD’S DETAILS:
*Family Name:
*Given Names:
*Gender:
*Date of Birth:
OR *Expected Birth:

PROPOSED BOOKING DETAILS:
Note: MICC offers a minimum of 2 days. Find out more
Day:	Monday	Tuesday	Wednesday	Thursday	Friday
Arrive:	.	.	.	.	.
Depart:	.	.	.	.	.
Can you be flexible with your selected times?
*Starting:		For: weeks / OR until:

PARENT / GUARDIAN APPLYING:
*Full Name:
Relationship to Child:	(click for quick insert: Mother, Father, Other Legal Guardian)
*Email: (a receipt of your booking will be sent to this e-mail if you specify one)
*Phone (Home)
OR *OR Phone (Work)
OR *OR Phone (Mobile)
Address:
Suburb:
Postcode:

ACCESS GUIDELINES

As a childcare service which receives Childcare Benefit from the Commonwealth Government, we abide by the priority of access guidelines set by the department of Family and Community Services. To help us equitably fill vacant places, please tick the appropriate boxes below:

APPLICATION
I wish to apply for placement as detailed above at the MARGARET IVES CHILDREN’S CENTRE INC. I understand that I must apply to FAO/Centrelink for Childcare Benefit if I intend to claim such benefit. (CCB application forms are available at the Centre and FAO) I understand that to maintain this place on the waiting list, I / We need to contact the Director of the Centre at least every three (3) months to confirm our continuing interest. Not doing so will mean the deletion of this application from the waiting list.
*I agree to all the points above.

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