Kindergarten Withdrawal/Deferral Form- Western

Kindergarten Withdrawal/Deferral Form
As per The Y Ballarat Policy, there is a withdrawal fee that will be applied to your account upon receipt of this completed form. The administration fee is $45.

A copy of our Fees Policy can be accessed on our website
Select the below that relates to you
Parent Name

First NameLast Name
Child Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Select Kindergarten
Select Child's Last Attendance Date

DayMonthYear
Date
Reason for Withdrawing
Select how you would like to pay the withdrawal fee
Account name
Bank Name
BSB
Account Number
Email- Remittance advice will be sent to this email once payment has been provided
example@example.com
Signature

Clear
Should be Empty: