Waiting Pool Form

Child's First and Last Names

Date of Birth

Desired start date

Sibling also applying (submit separately)

Do you know what days you will need? *

Yes, exactly as below.

Flexible, or don't know yet.

Select the days required (minimum two days)

Monday

Tuesday

Wednesday

Thursday

Friday

Contact parent's full name

Address

Phone

Email

One or both parents are a critical worker (key worker)

Is your child up to date with their immunisations? *

Yes

No

Please tell us about your child's care needs.

Why have you chosen Casa Montessori for your child?

How did you hear about Casa?

I confirm the information supplied is correct.

I have taken note of the eligibility criteria for ELC funding at CASA.View Fees page

I have read and understood the FAQ and terms and conditions and consent to being contacted by Casa using the details I have provided.

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