Osborne Park

08 9349 5577

Register your Interest

To secure a place on the waiting list, please complete the Expression of Interest form below.

Expression of Interest Form| Download Word Document or .PDF

Or complete the form digitally below.

1. Customer Reference Number

Child

2. Placement Preferences

Please select your prefered location

Number of days

Preference for days

Are you flexible with the amount of selected days?

Preferred Start Date

3. Child’s Details

Age

Sex

Date of Birth

 

4. Parent/Guardian Details

Parent/Guardian – 1

Date of Birth

 

Parent/Guardian – 2

Click the ‘Add’ button to add a second Guardian to submission

Date of Birth

 

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