Yarm Gwanga - Child care centre

Armidale, New South Wales, AUSTRALIA

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Sub sections:

Waiting list application for child care

Please complete all details.

You may either complete the online form below or print the Waiting list application form (PDF).

* indicates a required field.

Names

Parent A: eg Surname, First name

Parent B:

Home address

Home address:
Street address, incl Postcode

Contact details - Parent A

Phone number (home):

Phone number (work):

Mobile phone number:

Email address:

Contact details - Parent B

Phone number (home):

Phone number (work):

Mobile phone number:

Email address:

Child requiring care

Name:

Date of birth:

Sex:

Male Female

Days & hours care is required

Monday: Hours required

Tuesday: Hours required

Wednesday: Hours required

Thursday: Hours required

Friday: Hours required

Will you consider other days/times?:

Preferred date of commencement:

Parent A

If UNE employed:
State the UNE department or organisation.

If UNE student:
State the name of degree.

Mode of study:

Internal External

Level of employment/study:

Full time Part time

Parent B

If UNE employed:
State the UNE department or organisation.

If UNE student:
State name of degree.

Mode of study:

Internal External

Level of employment/study:

Full time Part time