Enrolment Form

St. Joseph’s N.S.

 Aughavas, Carrigallen, Co.Leitrim.

Ph. (071)9636326


 School Principal, Séamus Tiernan.


Application for Enrolment.



Child’s Name: ________________________ Nationality:_____________ PPS No.____________


Irish Version of Child’s Name


(Otherwise school will translate)




Date of Birth:______________________   Proposed date of Entry:________________________


Religious Denomination of Child:___________________________________________________


Date and Place of Baptism:_________________________________________________________

Father/Guardian’s name:____________________________



Mother’s/Guardian’s name:__________________________



Telephone No: (Home) _____________________  Telephone No: (Work) __________________




Person to be contacted in an emergency if Parents/Guardians are not available.


Name __________________________    Telephone  No: _______________________________


Previous School/preschool attended by your Child _____________________________________


Address: ___________________________________  Telephone No: _______________________


Please attach Records of educational progress, attendance etc. (If unavailable please provide provision for the attainment of same).


Reason for Transfer ______________________________________________________________


Class child is currently enrolled in :___________________________________________


Doctor:___________________________________  Telephone No:_________________________


Arrangements to be made if the Child is ill in school ___________________________________



Do you give permission to take the child straight to hospital in case of serious illness or accident? _____________________________________________________________________


Do you give permission for your child to take part in the S.P.H.E. (Social, Personal and Health Education Programme? _____________________________________________________




Has your child received any specialised (educational, emotional, physical) support ?



Please state relevant details of any condition/allergy/illness which may affect your child in School?




Does any legal order under family law exist that the school should know about?



The School should be made aware of any Court Order which affects the child’s welfare and also the name of any person into whose custody the child should not be given.




Photographs of school events/activities

Opportunities may present themselves to submit photo’s of events/activities to local press, websites etc.

Are you willing to allow your child’s name and photograph to be published? Yes  ___   No ___


As the parents or legal guardian of the above pupil, we have read the Acceptable Use Policy. We understand that Internet Access is designed for educational purposes. We also understand that the school cannot be held responsible if pupils access unsuitable websites, but that every reasonable precaution has been taken by the school to provide for online safety.

We grant permission for our son/daughter to access the Internet at school.

Yes  ___       No ___


School Website

We understand that, if the school considers it appropriate, our child’s schoolwork may be chosen for inclusion on our school’s Web site. We  understand and accept the terms of the Acceptable Use Policy relating to publishing children’s work on the school Web site.  

Yes  ___     No ___    


Do you give permission for your name, address & telephone number to be circulated regarding school related matters.

Yes  ___    No ___  


We have received and read a copy of ‘School Code of Behaviour and Discipline’. The Code of Behaviour provided is acceptable to us and we shall make all reasonable efforts to ensure compliance with this code by our  child. We  will co-operate with the Staff and support the ethos of the school.



Signature of Parent/Guardian:

_________________________________      Date:____________


(Please enclose your child’s Birth Certificate & Baptism Certificate with this application)