(This form can be copied and pasted to Microsoft word , printed and sent to the school)

 

                Scoil Naomh Pádraig,

              Drumfries, Co.Donegal. Tel:074 9363396

 

                       Application form for entry to school

 

Date of Enrolment:     / / 20                Year of proposed entry: 20___

 

Name of Child:________________________________________

Date of Birth: _____/____/____ Place of Birth: ___________________________

Nationality:____________________Religion: _______________________

P.P.S No:____________________

Father’s name:____________________Mother’s name: _______________________

Home Address______________________________________________________________

Mobile No: Father: __________________Mobile No: Mother:________________________

Telephone No.: Home: ______________________Work: _______________________

Email address: ______________________________________________________________

Occupation of Father: _______________Occupation of Mother:_______________________

 

                   BAPTISM & BIRTH CERTIFICATES MUST BE SUPPLIED

 

Has your child attended school /Pre- school previously?                   Yes/No

If yes, please state name of school _________________________________________

 

                                     Medical History of Child

 

 

Does your child suffer from any illness such as asthma, epilepsy or convulsions etc.?

If yes, please specify_____________________________________________

 

Is your child allergic to any foods? E.g. Nuts, fizzy drinks etc….

If yes, please specify ____________________________

 

 

 

 

 

Have health professionals ever expressed any concerns about your child’s development? E.g. Public Health Nurse, G.P, Audiologist etc…

If yes, please specify ______________________________________________

 

 

Has your child ever attended or is currently attending any of the following?

Speech therapy                                                            

Occupational therapy                                                   

Play therapy                                                                 

Other (Please specify)   ____________________________

 

*If any reports/ assessments of the above are available please inform the school

 

 

Emergency contact details

(Note: Please provide details of another contact in case of emergency should parents not be available- Also please keep school informed of any changes to contact details)

 

Name of contact person: _______________________Tel: _____________________

Name of Family Doctor: _______________________Tel:______________________

 

When the school finds it impossible to make contact with parents, I hereby give permission for my child to be taken to the family doctor/hospital.

 

Signature of Parent(1): ____________________ Date: _____________________

Signature of Parent(2): ____________________ Date: _____________________

 

All information given on this form will be treated in the strictest confidence and is for school purposes only to enable the school to cater appropriately for your child.

 

Note: The Stay Safe Programme is in use in this school

 

* Please note that a copy of the Child’s Birth Certificate must be provided for school records. (Department of Education and Science Circular 24/2002)