Killeen National School
Killeen, 
Louisburgh, 
Co. Mayo.

09868651
killeenns2@gmail.com
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Enrolment form
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.
Click here to download the enrolment form

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.

 

Contact us: 
Scoil Náisiúnta an Teaghlaigh Naofa

Killeen National School
Killeen, 
Louisburgh,
Co, Mayo

TEL: 098 68651
Email Address: killeenns2@gmail.com

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