APP form/Waiting List St. Joseph's Child Care 29 Mary Street, Lidcombe, NSW, 2141 Tel/Fax:(02) 9649 8374 ABN:25 978 559 890 Application for Waiting List Child information: Child D.O.B.: Sex:---MaleFemale Mother information: Are you currently: WorkingSeeking workUnemployedStudying Father information: Are you currently: WorkingSeeking workUnemployedStudying General information: Marital status:---MarriedSeparatedDivorcedWidowedDe facto Do you currently have child care:YesNo What days do you require care? MondayTuesdayWednesdayThursdayFriday Other information: Does your child have any special needs or disabilities?YesNo Does your child have any health issues?YesNo Date from which care is required: Please note:You might not get a place at the centre due to priority of enrolment or regulations. You should ring the centre every june and ask about your position on the list. If you change phone number or address you also to contact the centre and let us know. Did you use our centre before for an other child / children? YesNo Do you have more children at home?YesNo By filling out this form your child/children's name goes on to the waiting list. If you are not offered a place during the year, you will need to contact the centre to know whether you are still interested in remaining on the waiting list. Unfortunately there is no guarantee that you will be offered a place after a certain period of time. I agree to the Terms and Conditions Δ