Wiradjuri Enrolment Waiting List Form

Please complete and submit our Enrolment Waiting List form. If you have any queries about the enrolment process, contact Wiradjuri Preschool and Child Care Centre on (02) 6201 2087 or eMail WiradjuriPreschoolForward@canberra.edu.au.

Child 1 - Full Name (required)
Child 1 - Date of Birth
Child 1 - Toilet Trained? (required)	Yes No
Child 2 - Full Name
Child 2 - Date of Birth
Child 2 - Toilet Trained?	Yes No
Parent 1 - Full Name (required)
Parent 2 - Full Name
Address Line 1 (required)
Address Line 2
Address Line 3
Suburb (required)
State (required)
Postcode (required)
Email Address (required)
Home Phone (required)
Work Phone
Mobile Phone
Full time or Part time care? (required)
If part time care, which days?	Mon Tue Wed Thu Fri
Year(s) requested (required)	2020 2021 2022 2023 2024 2025
How did you hear about Wiradjuri?
Do you require a Tour of our Centre?
Any other information