Currawong Childcare Centre Currawong Childcare Centre Waiting List Application and Allocation Policy Revised – December 2010 Currawong Waiting List Application Currawong Childcare Centre will offer placements to a person (or persons) on completion of the Currawong Waiting List Application form. Once completed, the form needs to be returned to childcareaccounts@ywca-canberra.org.au. . An application who is a DFAT employee has priority over non-DFAT applicants. The details of the offer process, and how changes to an applicant’s needs for a place are managed, are set out in the Currawong Childcare Centre Allocation Policy. An application must indicate by written signature that the Allocation Policy has been read and understood. An applicant is responsible for updating information in relation to this application. As a minimum, an applicant must contact every six (6) months to confirm or amend information. Failure to do so will risk forfeiture of your application. When a place becomes available the applicant will be notified by email or phone if required. An applicant is asked to inform Currawong if the childcare place is no longer required.

### Applicant’s Name: Family Name (s): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Given Name (s): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Seek/s a Currawong Childcare place for the following child as its parent (s)/legal guardian (s) Family Name (s): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Given Name (s) [if available]: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Date of Birth (or estimated Date of Birth) \_\_\_\_\_\_/\_\_\_\_\_\_/\_\_\_\_\_\_ Please provide the child’s Date of Birth, an Estimated Date of Birth, or proof of authorisation to adopt Care is required from (Date) \_\_\_\_\_\_/\_\_\_\_\_\_/\_\_\_\_\_\_ For: M T W TH F (Please circle) Parent/Legal Guardian Parent/Legal Guardian Family Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Family Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Given Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Given Name \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Address \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Address \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Phone (H) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Phone (H) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (W) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (W) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (M) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (M) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Work Email \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Work Email \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Home Email \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Home Email \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (a) DFAT Employee? Yes/No (a) DFAT Employee? Yes/No If Yes, Peoplesoft Employee ID \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ If Yes, Peoplesoft Employee ID \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (found on your payslip) (found on your payslip) AGS number \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ AGS number \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Are you a DFAT contractor Yes/No Are you a DFAT contractor Yes/No If No to (a), place of work \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ If No to (a), place of work \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Is this work Casual/Part-time/Full-time? (Please circle) Is this work Casual/Part-time/Full-time? (Please circle)