Affiliate Membership Application (Childcare) | C&K - childcare and kindergarten

Section 1 – Centre Details

Registered Business Name *

Trading name (if different)

ABN *

GST registered *

Date of establishment *

Day

Month

Year

ARIA # (if known)

SEIFA # (if known)

KPP # (if known)

Approved Provider Number *

Approved Service Number *

Service Contact Name *

Contact's Position *

Phone *

Centre Email *

Mobile *

Centre Street Address *

Centre Postal Address *

Leave this field blank