Expression of Interest - Annagh National School

Enrolment Request Form Annagh NS

Expression of Interest Form
Annagh National School
Annagh, Miltown Malbay, Co Clare - V95 NP38
Phone:065 7084850
Email: secretary@annaghns.com

Name of child(Required)

PPS Number(Required)

Date of birth(Required)

Nationality

Gender(Required)

Language spoken at home

Mother’s name & Maiden name(Required)

Mother's Email Address

Mother’s occupation

Mother's Mobile No(Required)

Father's name

Father's Email Address

Father's occupation

Father's Mobile No(Required)

Class Joining(Required)

Year child begins school(Required)

Are either parents past pupils?(Required)

Please state their names and years attended

Does your child have siblings who have or are attending the school ?(Required)

Please give details

Home Address(Required)

Pre-school / previous school attended(Required)

I consent to Annagh National School liaising with my child's previous school / pre-school for information to aid planning purposes

Give Consent(Required)

Yes

Name of family doctor(Required)

Phone number of family doctor(Required)

IF CHILD BECOMES ILL IN SCHOOL PLEASE SUPPLY 3 EMERGENCY CONTACTS:

Contact 1

Contact 2

Contact 3

Additional Emergency contact details - name, mobile number, relationship to child(Required)

Any personal difficulties, allergies/illness that the school should be aware of(Required)

The Department of Education and Skills will hold data on all primary school pupils including their PPSN, First Name, Surname, Name as per Birth Certificate, Mother’s Maiden Name, Address, Date of Birth, Gender, Nationality, whether one of the pupil’s mother tongues is English or Irish, whether the pupil is in receipt of an Exemption from Irish and if so the reason for same, whether the pupil is in receipt of Learning Support and if so the type of learning support, whether the pupil is in a Mainstream or Special Class. The database will record the class grouping and standard the pupil is enrolled in. The database will also contain, on an optional basis, information on the pupil’s religion and on their ethnic or cultural background.

To which ethnic or cultural background group does your child belong?

What is your child's religion?

I consent for the sensitive personal data in the two questions above to be stored on the Primary Online Database (POD) and transferred to the Department of Education and Skills and any other primary school my child may transfer to during the course of their time in primary school.

Does your child attend any of the following? Please press Ctrl key to add multiple entries(Required)

More information about services attended

Any other relevant information

Signed (Please type your first and last name)(Required)

Date(Required)

**Please note completion of this form does not guarantee enrolment. Your request for enrolment will be considered and the school will be in contact with you regarding further documentation that may be required in accordance with the school Admissions Policy Data received on this form will be stored on our electronic system and used for school purposes only.

Please tick to confirm you have read, understood and accepted Annagh National School’s Code of Behaviour and Anti Bullying Policy

Terms and Conditions(Required)

I accept