East Melbourne Childcare Co-operative
About EMCC
Powlett Reserve
Yarra Park
Waiting List
Health and Food
Our Program
Home
Join the Waiting List
Leave the Waiting List
Waiting List
Join the Waiting List
The EMCC levies a non-refundable administration booking fee on all parents wishing to join the waiting list of $10.
No fee = no waiting list place.
Child's Details
Child's First name:*
Child's Sex:*
Male
Female
Unborn
Child's Date of Birth (Or Expected):*
(dd/mm/yyyy)
Care Requested:*
Full Time
Part Time
Date you want care to start from (ideally):*
(dd/mm/yyyy)
Does the child has sibling at EMCC?*
Yes
No
Address:*
Suburb:*
Postcode:*
Home Phone:*
(no spaces)
Your Details
Your Surname:*
Your First Name:*
Mobile Number:*
(no spaces)
Work Number:*
(no spaces)
Work Email Address: *
Please do
NOT
use free email accounts(e.g. yahoo, hotmail, gmail)
(A valid work email or email provided by your ISP is required)
Where do you work? *
- Select One -
Orica
City of Melbourne
City of Yarra
City of Port Phillip
Other
Preferred Language:*
Aboriginal or Torres Strait Islander:*
Yes
No
Do you have a partner?
*
Yes
No
Partner's Details
If you do not have a partner, please leave this section BLANK
Partner's Surname:
Partner's First Name:
Mobile Number:
(no spaces)
Work Number:
(no spaces)
Email Address:
(If no email address, please leave BLANK)
Where does your partner work?
- Select One -
Orica
City of Melbourne
City of Yarra
City of Port Phillip
Other
Language:
Aboriginal or Torres Strait Islander:
Yes
No
