Quality and affordable care for your child in leafy East Melbourne.

Join the Waiting List


    Child's Details

  2. Child's First name:*
  3. Child's Sex:*
  4. Child's Date of Birth (Or Expected):*
  5. Care Requested:*
  6. Date you want care to start from (ideally):*
  7. Does the child has sibling at EMCC?*
  8. Address:*
  9. Suburb:*
  10. Postcode:*
  11. Home Phone:*

    Your Details

  13. Your Surname:*
  14. Your First Name:*
  15. Mobile Number:*
  16. Work Number:*
  17. 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)
  18. Where do you work? *
  19. Preferred Language:*
  20. Aboriginal or Torres Strait Islander:*
  21. Do you have a partner?*

    Partners Details


    If you do not have a partner, please leave this section BLANK

  24. Partner's Surname:
  25. Partner's First Name:
  26. Mobile Number:
  27. Work Number:
  28. Email Address:
    (If no email address, please leave BLANK)
  29. Where does your partner work?
  30. Language:
  31. Aboriginal or Torres Strait Islander: