Mitchell Shire Council
Kindergarten Program Application

This is an application form only and does not guarantee a kindergarten placement

* Denotes the field is mandatory

Application Information

  • Application Type & Year

Preferences

  • Preference options will be shown once you have selected your registration type and application year

    Please only select preferences you will be willing to accept.

Child Details

  • Proof of Birth:

    We will accept – Birth Certificate, Immunisation History Statement or Passport. Please contact 5734 6200 if you don’t have any of these available to upload.

    JPG or PDF Format. Max 10MB in size.
  • Will the child's family/carer require an interpreter?

Parent/Guardian 1 Information

  • Postal address (if different from above)

  • Home Phone

    Business Phone

    Mobile Phone

  • Email addresses entered must match

Parent/Guardian 2 Information

  • Home Phone

    Business Phone

    Mobile Phone

Emergency Contact Information

  • Home Phone

    Business Phone

    Mobile Phone

Application Details

  • Legal Arrangement

  • Are there any court orders/access arrangements relating to your child?
    Supporting Documentation:
    JPG or PDF Format. Max 10MB in size.

  • Indigenous Status

  • Does your child identify as Aboriginal or Torres Strait Islander?

  • Multi Birth

  • Is your child a triplet/quad who is attending in the same year as their siblings?
  • Is your child a twin ?

  • Additional needs of the child

  • Does your child have any Developmental, Physical or Additional needs?
    Supporting documentation: Additional needs:
    Each document supplied must be in JPG or PDF format and no larger than 10MB in size.

  • Medical needs of the child

  • Does the child have any Allergies or Medical needs?
    Supporting documentation: Medical needs:
    Each document supplied must be in JPG or PDF format and no larger than 10MB in size.

  • 2nd Year of Kindergarten

  • Is this the second year of funded 4 year old kindergarten for the child?
    A second year of funded kindergarten may be considered when a child shows delays in key outcomes of learning and development.

  • Asylum Seeker/Refugee

  • Are you an Asylum Seeker or Refugee?

  • Concession/Visa Cards

  • Do you or your child hold a current health care card,concession card,humanitarian/refugee or bridging visa ?




  • Proof of Concession Card/Visa:
    JPG or PDF Format. Max 10MB in size.

Other Information

Authorisation and Declaration

  • By submitting this application the parent/guardian agrees and understands:
    • I declare that all of the information provided on this application is true and correct.
    • I have reviewed the preferences nominated for my child's application and understand it is my responsbility to contact council if these preferences change. I further acknowledge where incorrect information has been supplied on the application form (e.g. date of birth, selecting wrong kindergarten program) offers for places may be retracted,
    • I understand that kindergarten fees are compulsory and if unpaid my child's enrolment will be forfeited. Any unpaid fees will be referred to a debt collection agency and may lead to court proceedings and additional legal fees. Subsidies are available for concession card holders.
    • In the event of an emergency or my child being unwell, I must collect or make arrangements for the collection of my child as directed by the kindergarton educators.
    • This is an application form, not a gurantee of placement. Offers for kindergarten places will be made in the September prior to the application year.

Tick this box if you would like to register another child after submitting this application

Please make sure all fields are completed before clicking the Submit Application button.