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Your selected centre(s)

KU ANSTO, LUCAS HEIGHTS NSW 2234

Please complete the following form

CHILD DETAILS

PARENT/CARER DETAILS

Parent/Carer 1

Please provide your home/mobile number

Parent/Carer 2

ENROLMENT PREFERENCES

Preferred days of enrolment

ADDITIONAL INFORMATION

(This information is collected to determine priority of access according to Government Legislation and operational policy)

If you have an NDIS plan/number, please provide

KU ANSTO Children’s Centre – additional information to assist in determining priority of access

Please specify your end of term date if you are under a fixed term employment arrangement.

Which of the following applies to you?

Please tick all that apply

For Community Applicants

Which of the following applies to you?

Please specify the grandparent's name if the child’s grandparent is an ANSTO ongoing or fixed term employee