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network and get your listing underway please provide the following information. Fields marked with an asterisk (*) are required fields:
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parent
carer
agency
child care provider
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Registration Form
Name of Service
*
Type of Service
*
Please select one...
Child Care Centre / Provider
Child Care Agencies / In Home Care Services
Long Day Care
Family Day Care
Occasional Care
Pre-school
Before & After School Care
Vacation Care
Child Care Agency
In Home Care Provider
Contact Name
*
Address
*
Postcode
*
(numeric values only)
State
NSW
VIC
QLD
SA
WA
ACT
NT
TAS
Phone Number
*
Email Address
*
Please nominate the primary email address that you can be contacted on at all times
Child Care Fees
Long Day Care
Type
Fee
Age Group
(range)
Family Day Care
Type
Fee
Age Group
(range)
Occasional Care
Type
Fee
Age Group
(range)
Pre-school
Type
Fee
Age Group
(range)
Before & After School Care
Type
Fee
Age Group
(range)
Vacation Care
Type
Fee
Age Group
(range)
Approved service registered for
CCB
&
CCTR
Vacancies
*
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Please notify me when a parent registers for a vacancy matching the criteria above
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