Pupil Enrolment Form

Name of Child:_________________________________________________

Child’s Date of Birth _______________________

PPS N No.______________

Religious Denomination _________________________________________

Mother’s Name & Maiden Surname_______________________________

Father’s Name and Surname_____________________________________

Address:______________________________________________________

______________________________________________________________

Mother’s Mobile No. ——————————————————————————————————

Father’s Mobile No.______________________________________________

Contact email address________________________________________________

Other emergency contact and phone no.____________________________

______________________________________________________________

Name of Family Doctor: ___________________________________________

Doctor’s Tel Number:——————————————————————————————————

Does your Child have any medical concerns or allergies that the School should be

aware of?_________________________________________________________

_________________________________________________________________

Do you give permission for your Child to be taken to hospital in case of serious

illness or accident?___________________________________________

Do you give permission for your Child to be included in photographs of school groups that may on occasion be included in local publications or mentioned on the School Website?

_______________________

Do you give permission for your Child’ s involvement in our School RSE and Stay Safe Programmes_________________

If any Legal Order under Family Law exists  in relation to your Child please

 detail same_________________________________________________

Any previous School attended_______________________________

No. of years_______________________________

Class when leaving____________( Please attach any reports, test results etc.)

Any other useful information

Please note any additional relevant information in relation to your child that you feel  may impact on their School life

_____________________________________________________________

______________________________________________________________

Please ensure that you have included the following documents:

(A) Child’s Birth Certificate ( B) Baptismal Certificate ( if applicable)

( C)   Any  other relevant reports.

( Please include originals of these document for verification - they will be returned once photocopied)

We will co-operate with the staff and support the ethos of the School and work in line with School policies.

Signed:  _________________________________ Date_________________

Signed:_________________________ Date________________

Signed:_______________________ Date________________