Scoil Bhríde Enrolment Form

It is the parent/guardian's responsibility to read and complete this form carefully.

If you change your mobile phone number, address, or if there is any major change in who your child lives with, it is in your child's best interest to update the school.

All information will be treated with the utmost discretion. Thank you for your cooperation.

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1. Child's First Name (Required.)

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2. Child's Surname (Required.)

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3. Please enter your child's first name as it appears on their Birth Certificate (if different from above)

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4. Please enter your child's surname as it appears on their Birth Certificate (if different from above)

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5. PPSN (Required.)

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6. Date of Birth (Required.)

DOB

Date

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7. Nationality (Required.)

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8. Religion - Information required by the Department of Education & Skills (Required.)

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9. Name of Previous school attended (if applicable) (Required.)

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10. Contact Details (Required.)

Address Line 1

Address Line 2

Address Line 3

Eircode

Email Address

Phone Number

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11. Details of Family Doctor (Required.)

Name

Address Line 1

Address Line 2

Address Line 3

Phone Number

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12. Does your child have any health-related issues, such as serious allergies, epilepsy, diabetes, asthma, fainting etc? If yes, please detail below.

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13. Details of Parent/Guardian No 1 (Required.)

Full Name

Relationship to Child

Address Line 1

Address Line 2

Address Line 3

Phone Number

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14. Medical Card Number

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15. Social Welfare Number

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16. Details of Parent/Guardian No 2

Full Name

Relationship to Child

Address Line 1

Address Line 2

Address Line 3

Phone Number

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17. In the case of an emergency, if Parents/Guardians cannot be contacted, please provide details of adults who can accept responsibility for your child (Required.)

Name

Phone Number/s

Name

Phone Number/s

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18. Please tick the boxes below if you agree to the following:

Our child is allowed to take part in the Relationship & Sexuality Education (RSE) Programme

In the event that you cannot be contacted, in the case of an emergency your child may be taken to hospital by a member of staff

School may administer Literacy/Numeracy Assessments

Our child's photographs/work may be included on our Website/Facebook Page/Local or National Newspaper

Information may be shared between Pre-School/Primary & Secondary Schools

Our child's uniform may be changed by an adult member of staff in the presence of another adult in the case of illness or toilet accident

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19. Does any legal order under family law exist that the school should know about? (If yes, please email a copy at your convenience) (Required.)

Yes

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20. Do you consent to uploading data relating to your child's religion to POD (Department Database) (Required.)

Yes

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21. To which ethnic/cultural background does your child belong? (Required.)

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22. Do you consent to uploading data relating to ethnicity to POD (Department Database) (Required.)

Yes

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23. What Language is spoken at home? (Required.)

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24. Do you consent to uploading relevant data on this form to POD and Aladdin? (Required.)

Yes

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25. Have you read and agreed to the Code of Discipline? Click here for Code of Discipline (Required.)

Agree

Disagree

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26. Signature of Parent/Guardian 1 (Required.)

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27. Signature of Parent/Guardian 2

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28. Date Completed (Required.)

Date / Time

Date

100% of survey complete.

Scoil Bhríde Enrolment Form

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* 1. Child's First Name (Required.)

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* 2. Child's Surname (Required.)

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* 3. Please enter your child's first name as it appears on their Birth Certificate (if different from above)

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* 4. Please enter your child's surname as it appears on their Birth Certificate (if different from above)

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* 5. PPSN (Required.)

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* 6. Date of Birth (Required.)

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* 7. Nationality (Required.)

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* 8. Religion - Information required by the Department of Education & Skills (Required.)

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* 9. Name of Previous school attended (if applicable) (Required.)

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* 10. Contact Details (Required.)

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* 11. Details of Family Doctor (Required.)

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* 12. Does your child have any health-related issues, such as serious allergies, epilepsy, diabetes, asthma, fainting etc? If yes, please detail below.

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* 13. Details of Parent/Guardian No 1 (Required.)

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* 14. Medical Card Number

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* 15. Social Welfare Number

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* 16. Details of Parent/Guardian No 2

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* 17. In the case of an emergency, if Parents/Guardians cannot be contacted, please provide details of adults who can accept responsibility for your child (Required.)

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* 18. Please tick the boxes below if you agree to the following:

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* 19. Does any legal order under family law exist that the school should know about? (If yes, please email a copy at your convenience) (Required.)

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* 20. Do you consent to uploading data relating to your child's religion to POD (Department Database) (Required.)

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* 21. To which ethnic/cultural background does your child belong? (Required.)

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* 22. Do you consent to uploading data relating to ethnicity to POD (Department Database) (Required.)

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* 23. What Language is spoken at home? (Required.)

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* 24. Do you consent to uploading relevant data on this form to POD and Aladdin? (Required.)

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* 25. Have you read and agreed to the Code of Discipline? Click here for Code of Discipline (Required.)

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* 26. Signature of Parent/Guardian 1 (Required.)

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* 27. Signature of Parent/Guardian 2

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* 28. Date Completed (Required.)

1. Child's First Name (Required.)

2. Child's Surname (Required.)

3. Please enter your child's first name as it appears on their Birth Certificate (if different from above)

4. Please enter your child's surname as it appears on their Birth Certificate (if different from above)

5. PPSN (Required.)

6. Date of Birth (Required.)

7. Nationality (Required.)

8. Religion - Information required by the Department of Education & Skills (Required.)

9. Name of Previous school attended (if applicable) (Required.)

10. Contact Details (Required.)

11. Details of Family Doctor (Required.)

12. Does your child have any health-related issues, such as serious allergies, epilepsy, diabetes, asthma, fainting etc? If yes, please detail below.

13. Details of Parent/Guardian No 1 (Required.)

14. Medical Card Number

15. Social Welfare Number

16. Details of Parent/Guardian No 2

17. In the case of an emergency, if Parents/Guardians cannot be contacted, please provide details of adults who can accept responsibility for your child (Required.)

18. Please tick the boxes below if you agree to the following:

19. Does any legal order under family law exist that the school should know about? (If yes, please email a copy at your convenience) (Required.)

20. Do you consent to uploading data relating to your child's religion to POD (Department Database) (Required.)

21. To which ethnic/cultural background does your child belong? (Required.)

22. Do you consent to uploading data relating to ethnicity to POD (Department Database) (Required.)

23. What Language is spoken at home? (Required.)

24. Do you consent to uploading relevant data on this form to POD and Aladdin? (Required.)

25. Have you read and agreed to the Code of Discipline? Click here for Code of Discipline (Required.)

26. Signature of Parent/Guardian 1 (Required.)

27. Signature of Parent/Guardian 2

28. Date Completed (Required.)