Early Years Inclusion Services Request Form

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Centre/School Information

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Centre/School Contact Information

Your First Name:	Your Last Name:
Your Role (Job Title):	Email:
Phone Number:

What Early Years Inclusion Service are you enquiring about?

Kindy Inclusion Service Visit

This is a free service to QLD Approved Kindergartens including State Delivered Kindergartens.

If you are not requesting a visit, you can contact the phoneline if you wish to chat with an Early Years Inclusion Consultant on 07 3540 8610 (8:30am-3:30pm business days).

What would you like the visit to focus on? How can we support the Kindergarten program?

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INCLUDE Early Years Services

This is a fee for service consultancy service providing short and long term, coaching, education and learning to support inclusive approaches at your centre. This service can be paid for using funding including Kindy Uplift, Innovative Solutions, KISS, etc.

What funding are you using?

Kindy Uplift	Innovative Solutions	Kindergarten Inclusion Support Scheme
Other

Please specify other funding:

How would you like our service to support you? What are you wanting to focus on?

Please select service to enquire about.