Learning Sanctuary
Menu
Home
Why Us
Photo Gallery
Our Spaces
Contact Us
Home
Why Us
Photo Gallery
Our Spaces
Contact Us
Waitlist
Waitlist Form
Home
Waitlist Form
Waitlist Form
Home
-
Waitlist Form
Parent/Guardian 1
First Name*
Last Name*
Address*
Suburb*
Postcode*
E-Mail*
Mobile*
Parent/Guardian 2
First Name*
Last Name*
Address*
Suburb*
Postcode*
E-Mail*
Mobile*
Child’s Details
First Name*
Last Name*
Gender*
Male
Female
Date of Birth*
Start Date*
Days :
Monday
Tuesday
Wednesday
Thursday
Friday
Flexible with Days :
Yes
No
Have your child been in care before :
Yes
No
Orientation start Date:
Orientation Days :
Monday
Tuesday
Wednesday
Thursday
Friday
Please answer Yes or No as to whether your child has any of the following:
Triggers
Further Details (early intervention services your child is accessing)
Asthma
Yes
No
Anaphylaxis
Yes
No
Food Allergies
Yes
No
Food Preferences
Yes
No
Food Intolerances
Yes
No
Animal/Other Allergies
Yes
No
ADD/ADHD
Yes
No
Gifted/Talented
Yes
No
Speech
Yes
No
Behavioural Conditions
Yes
No
Cultural Beliefs
Yes
No
Other
Yes
No
Notes
Parents who already have a child in the Centre will get priority when a vacancy becomes available.
Our staff will contact you as soon as a position becomes available.
This form does not guarantee a place in the Centre.
