Add to waiting list

Please complete the form below to apply for enrollment at Star Early Learning, your registration will be added to our waiting list and you will be contacted by our manager for any further information and to let you know of the status of your enrollment application.

Please only submit one enrollment per child.

Child's Information

First Name *
Last Name *
Gender *
FemaleMaleWaiting till birth
Birthday *Expected date of birth if not yet known

Requested days and hours

Requested Start Date *Please choose from what date you are requesting from.
Requested Days
Please choose which days you are requesting your child attend.Monday
Start Time Please choose a start time you request your child attend.HHMM
End Time Please choose an end time you request your child attend.HHMM
Tuesday
HHMM
HHMM
Wednesday
HHMM
HHMM
Thursday
HHMM
HHMM
Friday
HHMM
HHMM
*Please note your child needs to be enrolled for a minimum of 6 hours per week, over 2 days

Parent/Caregiver (A)

First Name *
Last Name *
Mobile Phone *
Home Phone
Work Phone
Email *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Parent/Caregiver (B)

First Name
Last Name
Mobile Phone
Work Phone
Email
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Privacy Policy

Star Early Learning undertakes to collect, use and store the information you provide on this form according to the principles of the Privacy Act 1993. The information will be used to prepare rolls and records required by the Ministry of Education and Department of Work and Income for administrative purposes. Confidentiality will be maintained.
*
I certify that the above information is true and correct to the best of my knowledge, and by submitting this application I accept the terms, conditions and policies of the centre. I understand that by filling out this form is to put my child on the waiting list and that my child is not enrolled until an enrolment form has been filled and my hours have been accepted by the manager.

Verification

Please enter any two digits *Example: 12
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Don't BeFor more information, please contact us.

If you are interested, send us an enquiry and we will get back to you as soon as we can!