Early Childhood Centre Enquiry Form

What Centre would you like to be waitlisted for?

Please tick your first choice of Centre. We will do our best to accommodate your wishes, but it will depend on demand and the age of your child.

Your child/tamaiti

Child's first name

Child's surname

Child's date of birth

You may enter a due date if your child is not yet born at the time of filling out this form.

Child's gender

Child's ethnicity

Do you wish to register a second child for the Centre?

Second child's first name

Second child's surname

Second child's date of birth

You may enter a due date if your child is not yet born at the time of filling out this form.

Second child's gender

Second child's ethnicity

Whānau/Caregiver details

Parent/Caregiver name

Home address

Contact phone number

Email address

Whānau status

University ID number

Further information

Does your child have any health or dietary requirements?

If yes, please provide details:

Please indicate below the days and hours you wish your child to be booked in for.
Please indicate the times of day that your child would be at the centre, not just the amount of hours.

For example:
Monday: 5 hours, 10am-3pm
Tuesday: 8 hours, 8am-4pm
Total hours: 13 hours

Monday

Tuesday

Wednesday

Thursday

Friday

Total hours

Requested commencement date

By ticking this box, I confirm that the above information is correct. I understand that submitting this form does not guarantee my child a place in a University of Auckland ECE Centre.

Please do not enter any credit card information into this form.

Early Childhood Centre Enquiry Form