Application for Enrolment in

Court N.S.,

Monamolin,
Gorey,

Co.Wexford.

"Ar aghaidh le chéile"

Name of child:  
Address:  
   
   
   
   
Date of Birth:  
Name of Parent(s) \ Guardian(s)  
   
Address of Parent(s) \ Guardian(s)  
   
   
   
   
Telephone Number   Daytime Number:   Emergency Number:  
Name and address of  
previous Primary School  
(if applicable)  
   
   
Reason for transferring  
(if applicable)  
   
   
Religion:  
   
Church where baptised  
(if applicable)  
   
   
Name of Doctor:  
Address:  
   
   
   
Tel No:  

 

If your child suffers from any disability or long term illness which you feel the school should be aware of please specify below.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Please indicate below if your child has been assessed in any of the following areas. If so, please furnish the school with a copy of same, at your earliest convenience.

 

  Please tick
Educational Assessment  
Psychological Assessment  
Psychiatric Assessment  

In the event of a serious illness \ accident to my child (if I cannot be contacted) I give permission for him \ her to be brought to his \ her doctor.

 

Signed ___________________________ Date ________________________

 

 

Please be assured that all information on this form is private and confidential.

 

The BOM Court NS will inform you in writing within 21 days of their decision concerning this application for enrolment.

 

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