Enrolment Form - tinahely national school

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Enrolment Form

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TINAHELY NATIONAL SCHOOL.

APPLICATION FOR ADMISSION OF NEW PUPILS : YEAR _`

NAME OF CHILD...................:_______________________________________

DATE OF BIRTH...................:_______________________________________

FATHER'S NAME...................:_______________________________________

MOTHER'S NAME & MAIDEN SURNAME..:_______________________________________

HOME ADDRESS....................:_______________________________________

TELEPHONE NUMBER...........:HOME ____________ WORK _____________ MOBILE ___________

RELIGIOUS DENOMINATION..........:_______________________________________

DATE & PLACE OF BAPTISM.........:_______________________________________

PARENTS' OCCUPATIONS............:_______________________________________

ANY PREVIOUS SCHOOL ATTENDED....:________________________CLASS__________(that school)

LOCAL CONTACT IN CASE OF EMREGENCY,
IF PARENTS CAN’T BE CONTACTED...:_______________________________________
(Give name and telephone number)

NAME OF FAMILY DOCTOR...........:_______________________________________

IRISH VERSION OF CHILD'S NAME...:_______________________________________
(Otherwise school will translate)

DO YOU GIVE PERMISSION TO TAKE
YOUR CHILD ON SCHOOL TRIPS? _______________________________________

DO YOU GIVE PERMISSION FOR YOUR CHILD TO TAKE PART IN
THE STAY SAFE PROGRAMME AND THE RSE PROGRAMME ? ________________


CHILD’S PPS NUMBER:______________________MEDICAL CARD NUMBER ____________ (If applicable)

HAVE YOU ATTACHED? (a) BIRTH CERT __________ (b) BAPTISMAL CERT ____
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ANY OTHER USEFUL INFORMATION

For instance, list any problems the child may have in relation to health,( allergies,
epilepsy, asthma, sight, hearing, speech, fainting, etc.) toilet training, inability to cope with buttons, laces etc. If you think you are eligible under the FREE BOOK scheme, please indicate if you have
a medical card or other SW entitlement.
The school should be made aware of any court order which affects the child's welfare
and also the name of any person into whose custody the child should not be given.
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________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________
We have received and read a copy of "School Rules & Code of Discipline".
We will co-operate with the staff and support the ethos of the school.

SIGNED :________________________ Parent
DATE :_______________

 
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