Kidsxap-Enrolment-Form

Enrolment Form

Please select the centre

Start New Application

Edit Existing Application

Parent / Guardian Details

Email Address *

First Name *

Middle Name

Last Name *

Date of Birth *

Gender *

Relationship to Child

Mobile *

Work Phone

Home Phone

Address

State

Suburb

Postcode

Indigenous Indicator

Cultural background

Language(s) spoken at home

Employment Information

Level Of Education

Qualification

Employment Status

Job Title/Occupation

Occupation Group

Employer/Organisation Name

Employer/Organisation Address

To qualify for the Childcare Subsidy (CCS), you MUST provide your Customer Reference Number (CRN) below. If you do not have a CRN, you need to register for Centre link Online Services by contacting 136150. You can still complete this enrolment if you do not have your CRN yet.

CRN Number

Consents

I authorise the centre to contact me in case of an Emergency.

I consent that I have the drop off and pick up authority of the child listed in this application.

+ Add Another Guardian

Add Child Details

Booking Details