Welcome to Kogarah UnitingCare Long Day Care Centre

Application for Waiting List
Please note the waiting list is open
for the following ages;

0-2 years

2-3 years

3-5 years

Please complete the following information and press Submit
* indicates field is mandatory

Child's Information:

Child's Name:

Date of Birth:

Child's Age:

Under 2 years
2 -3 years:
Over 3 years

Date care required:

Days Required:
(please tick)

Mon	Tue	Wed	Thur	Fri

Family Information:

*Parent Names:

Address:

State: Post Code:

Phone:

Mobile:

*Email:

Languages spoken:

Other information you feel is important for us:

Method of payment:

Acceptance of this application is subject to receipt of $10 waiting list fee.

Please let us know how you found out about us:

Website	Current parent	Other

To contact us:
Phone: Fax: Email:	02 9587 6474 02 9553 9407 kogarahdaycare@hotmail.com		18 Gray Street PO Box 833 Kogarah NSW 1485