La Trobe University > Children's Centre > Forms > Autism Specific Early Learning and Care Centre - Margot Prior Wing

Autism Specific Early Learning and Care Centre - Margot Prior Wing

Waitlist application

To be placed on the Autism Specific Early Learning and Care Centre - Margot Prior Wing waitlist, please complete the form below and we will contact you as soon as possible.

Childs details
Date of birth *
Number of days and which days?
Diagnosis of Autism Spectrum Disorder? *
Immunisation

**All children attending the centre must be immunised.**

Please note: Parents must provide evidence from the Australian Immunisation Register (AIR) before a placement can commence.

 
Parent/Guardian details

Please note: Priority of Access Guidelines are used to allocate child care places where more applications are received than the number available.

Priority access
Please select one of the following options that best describes your family circumstances:
Priority categories * Please select one or more of the following categories that best describes your family circumstances:
Association

 

 

 

Privacy statement

La Trobe respects the privacy of your personal information. The information we collect is for the purposes of providing a professional child care service and educational program for your child(ren). If your personal information is not provided to us then we cannot offer you our services. You may have the right to access the personal information we hold about you subject to any exemptions in relevant laws, by contacting us on children@latrobe.edu.au.