Holroyd City Council

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Childcare Waiting List Application Form

Completing this form and clicking submit will place you on the waiting list for a spot in one of our childcare services or with a family day care provider. There is no fee for being on the waiting list and you are not obligated to accept a place with us when one becomes available.

The information collected below will be used to: place you on the appropriate waiting list/s; contact you about available vacancies and other services; assess your needs according to the Priority of Access Guidelines; and to provide the best possible care for your child. Your details will be kept secure and can be updated by you at any time by contacting Children's Services.

To receive the Child Care Benefit (CCB) you must provide the Customer Reference Numbers (CRN) for your child and one parent. To get help obtaining a CRN phone Family Assistance Office on 136 150. Only the first parent can receive the Child Care Benefit. Please see the responsibilities of the parent receiving the CCB.
You must have an email address in order to complete the form online. If you are unable to complete the form below you can print and post in the Childcare Application Form.

Parents who need care for their school-age children during the school holidays should investigate holiday care.


Care Options (required)
  1. When you would like care to begin
  2. Type of Care
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  3. Preferred Long Day Care Centre
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  4. Preferences for Family Day Care
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  5. Preferred Area
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  6. The school your child attends determines which centre we will place them in.
  7. Days Care Needed
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  8. Times Care Needed
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  9. : :
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  14. If a place becomes available at a time different to what you've requested would you be interested?Being flexible makes it easier for us to offer you a place
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Child's Details (required)
  1. Gender
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  5. For example, 16 Fairfield Road
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  8. You must have a Customer Reference Number to receive any form of rebate. Contact Family Assistance on 136 150 for information.
  9. State any disability/medical conditions (e.g diabetes, allergies) so we can cater for your needs
First Parent's Details (required)
  1. Title
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  4. Needed to receive the child care benefit
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  1. For example, 16 Fairfield Road
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  4. We will send you an email confirming that we have received your form
  5. All phone numbers must contain only numbers, no spaces (example: 98409840).
  8. Only the first parent can receive the Child Care Benefit.
  9. Employment StatusUsed to determine priority of placement
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  10. State any disability/medical conditions (e.g diabetes, allergies) so we can cater for your needs
Second Parent's Details
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  1. Title
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  4. Needed to receive the child care benefit
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  1. For example, 16 Fairfield Road
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  8. Employment StatusUsed to determine priority of placement
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  9. State any disability/medical conditions (e.g diabetes, allergies) so we can cater for your needs
  1. Do you agree to inform the centre of any changes to this information?
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  2. How did you hear about us?
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