Requested start date (required) If not firm date, please write 'next available'. There are no guarantees of placement by the requested date. Availability is dependent on vacancies in your child's age group.
Number of days required (required)
Booking type (required) All year roundUni session (conditions apply)
Days requested (required) MondayTuesdayWednesdayThursdayFriday Multiple options can be selected.
Are you flexible on days (required) YesNo
Centre Preference (required) Kids' Uni NorthKids' Uni SouthKids' Uni CBDKids' Uni Innovation Campus (2-6 years only)First Available Position/Any Service To select more than one centre preference, press and hold the 'CTRL' button whilst selecting multiple options.
CHILD'S DETAILS
Child's First Name (required)
Child's Surname (required)
Date of Birth or Due Date (required)
Child's Address (required)
PARENT/GUARDIAN 1 DETAILS
Parent/Guardian 1 First Name (required)
Parent/Guardian 1 Surname (required)
Parent/Guardian 1 Address (required)
Parent/Guaridan 1 Occupation (required)
Parent/Guardian 1 Phone Mobile (required)
Parent/Guardian 1 Phone Work
Parent/Guardian 1 Phone Home
Parent/Guardian 1 Email (required)
Parent/Guardian 1 Employer (required)
Parent/Guardian 1 Hours of Work (required)
PARENT/GUARDIAN 2 DETAILS
Parent/Guardian 2 First Name
Parent/Guardian 2 Surname
Parent/Guardian 2 Address
Parent/Guardian 2 Occupation
Parent/Guardian 2 Phone Mobile
Parent/Guardian 2 Phone Work
Parent/Guardian 2 Phone Home
Parent/Guardian 2 Email
Parent/Guardian 2 Employer
Parent/Guardian 2 Hours of Work
PRIORITY OF ACCESS -
The answers you give here will determine your priority of access PRIORITY 1 Is this child currently declared 'at risk' of serious abuse or neglect by Department of Communities and Justice, Police, other agencies or this service? (required) YesNo
If YES, please give details
PRIORITY 2
Please complete details for any Sibling/s currently enrolled at a Kids' Uni service Any other Sibling/s currently enrolled at a Kids' Uni service YesNo
Sibling Name Sibling Date of Birth Silbing Enrolled Centre NorthSouthCBDInnovation Campus
Sibling Name Sibling Date of Birth Sibling Enrolled Centre NorthSouthCBDInnovation Campus
PRIORITY 3
Are you a family with both parents working or studying for future employment? OR a single parent working or studying for future employment? (required) *You must satisfy the work/training, study test under Section 14 of the 'A New Tax System (Family Assistance) Act 1999' YesNo
Are you a current student of UOW (required) YesNo
Student Number. Please note proof of enrolment will be required on offer of placement Are you a current staff member of UOW or UOW Pulse? (required) YesNo
Faculty/Department
PRIORITY 4
Any other child (required) If you do not satisfy the work/study requirements above. (Example: if one or both parents are not studying or working). Please note: We may require a Priority 4 child to vacate a place to make room for a child with a higher priority, 14 days written notice will be provided in these situations. YesNo
ADDITIONAL INFORMATION
These questions are optional, however please note if you opt to not answer the below questions, it can affect your priority of access. Does Your family identify as Aboriginal and/or Torres Strait Islander? YesNo Does your child or an immediate family member living within your household have a disability? YesNo Does your child have additional needs? This may include, but is not limited to, a family experiencing social isolation or a newly arrived family or refugee background? YesNo If you have answered YES to the above two questions, please briefly explain the nature of the disability or additional needs.
Do you have Siblings on Waiting List (Name)
I understand and agree to notify Kids' Uni should my circumstances change in order to keep all information up to date.
Relationship to child (required)
Date (required)
Additional Comments
