Enrolment form
Scoil Náisiúnta an Teaghlaigh Naofa
Killeen, Louisburgh, Co. Mayo
killeenns2@gmail.com
www.killeenns.com
(098) 68651
Scoil Náisiúnta an Teaghlaigh Naofa
Killeen, Louisburgh, Co. Mayo
killeenns2@gmail.com
www.killeenns.com
(098) 68651
Please call us on 098 68651 to request an enrolment form or alternatively, call into the school to collect one.
APPLICATION FOR ADMISSION OF NEW PUPILS
NAME OF PUPIL: _______________________________________________________
PPS NO: _______________________________________________________
GENDER: _______________________________________________________
DATE OF BIRTH: _______________________________________________________
ADDRESS: _______________________________________________________
_______________________________________________________
EIRCODE: _________________________________________________________
HOME PHONE NO: _______________________________________________________
RELIGION: _______________________________________________________
IRISH VERSION OF CHILD’S NAME: _____________________________________________
FORMER SCHOOLS: _______________________________________________________
CLASS IN FORMER SCHOOL: __________________________________________________
FATHER’S NAME: _______________________________________________________
MOBILE NUMBER: _______________________________________________________
WORK NUMBER: _______________________________________________________
OCCUPATION: _______________________________________________________
MOTHER’S NAME: _______________________________________________________
MOBILE NUMBER: ______________________________________________________
WORK NUMBER: _______________________________________________________
OCCUPATION: _______________________________________________________
School text messages will automatically be sent to the mother’s mobile number. Please indicate if you would like messages to be sent to a different number: ___________________________
We endeavour to communicate letters and newsletters to parents via email. Please continue to check your child’s schoolbag for occasional notes/letters. Please leave blank if you would prefer not to receive correspondence by email.
EMAIL ADDRESS(ES): ____________________________________________________________
___________________________________________________________________
IF OTHER MEMBERS OF THE FAMILY ALREADY ATTEND KILLEEN NS PLEASE STATE:
NAME: ________________________________ CLASS: __________________________________
NAME: ________________________________ CLASS: __________________________________
IS YOUR CHILD LIVING WITH (PLEASE CIRCLE):
BOTH PARENTS ONE PARENT GRANDPARENTS CARERS OTHER
WHO ARE THE LEGAL GUARDIANS OF YOUR CHILD:
______________________________________________________________________________
NAME, ADDRESS AND PHONE NUMBER OF FAMILY DOCTOR:
___________________________________________________________________________
______________________________________________________________________________
ANY CHILDHOOD ILLNESSES/ALLERGIES:
______________________________________________________________________________
ANY MEDICAL PROBLEMS: ________________________________________________________
IS YOUR CHILD ON ANY MEDICATION? _________________________________________________
ANY PROBLEMS WITH HEARING, SIGHT, SPEECH AND LANGUAGE? ___________________________
______________________________________________________________________________
ARRANGEMENTS TO BE MADE IF YOUR CHILD IS ILL IN SCHOOL:
__________________________________________________________________________________________
While we make every effort to ensure the safety of your child, we may need to contact you in the event of an accident or an unexpected closing.
Please fill in the following:
Emergency / Alternative Contact (not your own number):
NAME: ________________________________________________________________
ADDRESS: _____________________________________________________________
PHONE NUMBER: _______________________________________________________
PLEASE ATTACH CHILD’S BIRTH CERTIFICATE WHICH WILL BE RETURNED.
Should any of these details change while your child is attending the school please inform us immediately.
NAME OF PUPIL: _______________________________________________________
PPS NO: _______________________________________________________
GENDER: _______________________________________________________
DATE OF BIRTH: _______________________________________________________
ADDRESS: _______________________________________________________
_______________________________________________________
EIRCODE: _________________________________________________________
HOME PHONE NO: _______________________________________________________
RELIGION: _______________________________________________________
IRISH VERSION OF CHILD’S NAME: _____________________________________________
FORMER SCHOOLS: _______________________________________________________
CLASS IN FORMER SCHOOL: __________________________________________________
FATHER’S NAME: _______________________________________________________
MOBILE NUMBER: _______________________________________________________
WORK NUMBER: _______________________________________________________
OCCUPATION: _______________________________________________________
MOTHER’S NAME: _______________________________________________________
MOBILE NUMBER: ______________________________________________________
WORK NUMBER: _______________________________________________________
OCCUPATION: _______________________________________________________
School text messages will automatically be sent to the mother’s mobile number. Please indicate if you would like messages to be sent to a different number: ___________________________
We endeavour to communicate letters and newsletters to parents via email. Please continue to check your child’s schoolbag for occasional notes/letters. Please leave blank if you would prefer not to receive correspondence by email.
EMAIL ADDRESS(ES): ____________________________________________________________
___________________________________________________________________
IF OTHER MEMBERS OF THE FAMILY ALREADY ATTEND KILLEEN NS PLEASE STATE:
NAME: ________________________________ CLASS: __________________________________
NAME: ________________________________ CLASS: __________________________________
IS YOUR CHILD LIVING WITH (PLEASE CIRCLE):
BOTH PARENTS ONE PARENT GRANDPARENTS CARERS OTHER
WHO ARE THE LEGAL GUARDIANS OF YOUR CHILD:
______________________________________________________________________________
NAME, ADDRESS AND PHONE NUMBER OF FAMILY DOCTOR:
___________________________________________________________________________
______________________________________________________________________________
ANY CHILDHOOD ILLNESSES/ALLERGIES:
______________________________________________________________________________
ANY MEDICAL PROBLEMS: ________________________________________________________
IS YOUR CHILD ON ANY MEDICATION? _________________________________________________
ANY PROBLEMS WITH HEARING, SIGHT, SPEECH AND LANGUAGE? ___________________________
______________________________________________________________________________
ARRANGEMENTS TO BE MADE IF YOUR CHILD IS ILL IN SCHOOL:
__________________________________________________________________________________________
While we make every effort to ensure the safety of your child, we may need to contact you in the event of an accident or an unexpected closing.
Please fill in the following:
Emergency / Alternative Contact (not your own number):
NAME: ________________________________________________________________
ADDRESS: _____________________________________________________________
PHONE NUMBER: _______________________________________________________
PLEASE ATTACH CHILD’S BIRTH CERTIFICATE WHICH WILL BE RETURNED.
Should any of these details change while your child is attending the school please inform us immediately.
