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Application to EnrolContent First2020-05-06T16:55:44+10:00

Application to Enrol

In order to further proceed with our enrolment process, please complete the Application to Enrol Form below.

Note your preferred centre is being pre-filled from our system based on our records, if this is not correct please contact us.

Select your centre*
Name*
First Last
Email*
Phone*
Residential / Suburb / Postcode
I would like to enrol*

1st Child Information
Child 1's firstname*
Child 1's Surname*
Child 1's CRN
Child 1's DOB*
DD slash MM slash YYYY
Gender
- Male
- Female
Booking Details
Child 1's Approximate Times of Attendance
Child 1's Preferred Start Date*
DD slash MM slash YYYY
What days are you interested in?*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Immunisation Details
Child 1's Immunisation Details
- Birth
- 2 Months
- 4 Months
- 6 Months
- 12 Months
- 18 Months
- 4 Years
Important Information About Your Child
What is your child's cultural background/nationality?
Is your child of Aborginal, Torres Strait Island descent?
- Yes
- No
- Both
- Neither
Primary language of the family?
Does your child have any religious, cultural or personal beliefs that require consideration from our Centre?
- Yes
- No
Does/can your child participate in festivals/celebrations?
- Yes
- No
Does your child have any special dietary needs? i.e. vegetarian
- Yes
- No
Child Health Record
Does your child have Asthma?
- Yes
- No
Does your child have Anaphylactic reactions?
- Yes
- No
Does your child have Allergic reactions?
- Yes
- No
Does your child have have any medical conditions other than the above mentioned?
- Yes
- No
Is your child at risk of a life threatening reaction?
- Yes
- No
Childcare Subsidy Information
Is your child eligible for the childcare subsidy?
- Yes
- No
Has your child attended another childcare facility this financial year?
- Yes
- No

2nd Child Information
Child 2's Firstname*
Child 2's Surname*
Child 2s CRN
Child 2's DOB*
DD slash MM slash YYYY
Gender
- Male
- Female
Booking Details
Child 2's Approximate Times of Attendance
Child 2's Preferred Start Date*
DD slash MM slash YYYY
What days are you interested in?*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Immunisation Details
Child 2's Immunisation Details
- Birth
- 2 Months
- 4 Months
- 6 Months
- 12 Months
- 18 Months
- 4 Years
Important Information About Your Child
What is your child's cultural background/nationality?
Is your child of Aborginal, Torres Strait Island descent?
- Yes
- No
- Both
- Neither
Primary language of the family?
Does your child have any religious, cultural or personal beliefs that require consideration from our Centre?
- Yes
- No
Does/can your child participate in festivals/celebrations?
- Yes
- No
Does your child have any special dietary needs? i.e. vegetarian
- Yes
- No
Child Health Record
Does your child have Asthma?
- Yes
- No
Does your child have Anaphylactic reactions?
- Yes
- No
Does your child have Allergic reactions?
- Yes
- No
Does your child have have any medical conditions other than the above mentioned?
- Yes
- No
Is your child at risk of a life threatening reaction?
- Yes
- No
Childcare Subsidy Information
Is your child eligible for the childcare subsidy?
- Yes
- No
Has your child attended another childcare facility this financial year?
- Yes
- No

3rd Child Information
Child 3's Firstname*
Child 3's Surname*
Child 3's CRN
Child 3's DOB*
DD slash MM slash YYYY
Gender
- Male
- Female
Booking Details
Child 3's Approximate Times of Attendance
Child 3's Preferred Start Date*
DD slash MM slash YYYY
What days are you interested in?*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Immunisation Details
Child 3's Immunisation Details
- Birth
- 2 Months
- 4 Months
- 6 Months
- 12 Months
- 18 Months
- 4 Years
Important Information About Your Child
What is your child's cultural background/nationality?
Is your child of Aborginal, Torres Strait Island descent?
- Yes
- No
- Both
- Neither
Primary language of the family?
Does your child have any religious, cultural or personal beliefs that require consideration from our Centre?
- Yes
- No
Does/can your child participate in festivals/celebrations?
- Yes
- No
Does your child have any special dietary needs? i.e. vegetarian
- Yes
- No
Child Health Record
Does your child have Asthma?
- Yes
- No
Does your child have Anaphylactic reactions?
- Yes
- No
Does your child have Allergic reactions?
- Yes
- No
Does your child have have any medical conditions other than the above mentioned?
- Yes
- No
Is your child at risk of a life threatening reaction?
- Yes
- No
Childcare Subsidy Information
Is your child eligible for the childcare subsidy?
- Yes
- No
Has your child attended another childcare facility this financial year?
- Yes
- No

Any questions?
How did you hear about us?*

Consent*

I have read and understood the terms of the Petit ELJ Privacy Policy.*

Petit ELJ may use or disclose your personal information for the primary purpose for which it was collected, or for any reasonably expected or related secondary purpose which includes communicating directly with you to promote our services or where you have provided your express or implied consent.

By providing your personal information to us, you consent to the use of your information for the purposes noted above. A full copy of our Privacy Policy can be located on our website at Privacy Policy.

You may receive email updates about our centres and occasional SMS reminders on the important information that we may require from you.

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1 300 1 73848
enquiries@petitjourney.com.au
PO Box 10829, Brisbane, QLD 4001

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