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castletownshendns@gmail.com

Castletownshend National School

APPLICATION FOR ENROLEMENT FORM  

Castletownshend National School | www.castletownshendns.ie | Castletownshend National School

CASTLETOWNSHEND NATIONAL SCHOOL  

APPLICATION FOR ENROLEMENT FORM  

 CONFIDENTIAL  For office use only: Registration Number: ________  

Please see Castletownshend National School’s Data Protection Policy (in folder) which was formed in  alignment with the D.E.S. Data Protection Policy on the use of POD (further information available  on the Department’s website www.education.ie) and under GDPR guidelines. This outlines how we  collect, use, store and safeguard your child’s personal data.  

Pupil Forename ……………………………… Pupil Surname: ………………………..

 Birth Certificate Forename: …………………. Birth Certificate Surname: …………… 

Irish Version of Name:………………………………………………………………………….. Address: ………………………………………………………………………………………… 

………………………………………………………………………………………… Post Code: ………………………………………………………………………………………. Date of Birth:……………………………………………………………………………………. Name of Father:…………………………………………… Occupation:……………………… Name of Mother:………………………………………….. Occupation:……………………… 

Mothers Maiden Surname: ………………………………. 

P.P.S. No. of Child ………………………………………. 

Is one of the pupil’s mother tongues (i.e. the language spoken at home) Irish or English? Yes/ No 

Parent/ Guardian Contact Details 

Home Phone Number: …………………… 

Mothers mobile Number: ………………… Mother’s Email (optional): ………………………………….. Fathers Mobile Number: …………………. Father’s Email (optional) …………………………………… Mobile Number you wish to be contacted on by School’s Text Messaging Service: …………………….. Does any legal order under Family Law exist that the school should know of? …………………………… ……………………………………………………………………………………………………………….. Contact through email: 

I wish to receive any school Newsletter and Notes to the following email  address:……………………………………………………………………………………………………….

 Is it necessary for school reports, notice of meetings e.t.c. to be sent to more than one address? Please  provide name, address phone number and email address of that person. 

………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………. Emergency Contact Sequence: (if both parents are unavailable) 

Name of Contact Role (eg Granny , Aunt etc.) Mobile Number Home Number 

 1. ___________________ _____________________ _____________ ______________ 2. ___________________ _____________________ _____________ ______________ 3. ___________________ _____________________ _____________ ______________ 4. ___________________ _____________________ _____________ ______________

Number of children in the family:……………………………………………………………… Position of this child in the family:…………………………………………………………….. Has he/she brothers/sisters in the school?……………………………………………………… Names and ages of brothers/sisters 

First name Age First name Age 

…………. …… …………. …… 

…………. …… …………. …… 

…………. …… …………. …… 

_______________________________________________________________________________ Medical and allergy Information. 

Has the child any health related problems e.g. asthma, epilepsy, diabetes, fainting allergies etc?  If yes please give details and any special instructions.  

………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………. 

Did your child attend the Early Intervention services? ……………………… If yes, please attach reports. Has your child ever had a psychological assessment?……………………………….. If yes please attach reports. Does your child have any difficulties with speech or ever received a speech and language report?…………. …………………………………………………………………………………If yes please attach reports. Does your child have any difficulties with hearing?…………………………………………………………………………….. 

Does your child have any difficulties with vision?………………………………………………………………………………. Does your child have any issues socially or behaviourally that the school should know about? ………………………………………………………………………………………………………………. If your child has any other health related problems that the school should know about please provide copies  of all relevant psychological or assessment reports to assist the board of management in making an  informed decision on enrolment. 

………………………………………………………………………………………………………………… Optional Information 

Name and Contact details for child’s Doctor : 

………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….

ENROLMENT OF NEW INFANTS ONLY:  

Has the child attended play-school/pre-school?……………………………… 

If yes, where?……………………………………………………………………. 

Can the child look after 1. Belongings: ……. 

2. Toilet needs: ……. 

3. Shoelaces: ……. 

How is the child to go home at 2 o’ clock? ………………………………………….. Have you signed an Indemnity Form? …………………………………………… __________________________________________________________________________________ CONSENT ( please ensure that you complete this section of the form. 

Relationship & Sexuality Education Consent 

Relationship and Sexuality Education (R.S.E.) will be taught to your child and anatomically correct  wording is used at class appropriate level as laid down by the Department of Education. Do you give consent for your child to receive the appropriate instruction in R.S.E. (Relationships &  Sexuality Education). This consent will apply for the duration of the child’s education in Castletownshend  N. S. : Yes /No ………………………………………………………………………………………………… If you would like more information on the RSE programme please see www.staysafe.ie 

Internet Consent 

Do you give permission for your child to use the School Internet in accordance with the school Internet  policy: Yes / No ………………………………………………………………………………………………. 

School Trips Consent 

Do you give permission for your child to go on school trips under teacher supervision? Yes / No …………. 

HSE and Parish Consent 

Annually the school is asked to provide information to the HSE to facilitate their work, immunizations,  sight and hearing tests and dental appointments etc. and to the Parish Office for preparation for the  Sacraments. Do you give permission for your child’s details to be made available? Yes / No ……………… 

Injury Consent 

Do you give permission for your child to be treated for minor accidents (e.g. cuts, grazes)? Yes / No ……… Do you give consent to the staff of Castletownshend N.S. to obtain professional medical aid for your child  in the case of a medical emergency or serious injury Yes / No ………………………………………………. Please ensure that you familiarize yourself with the school accident policy.

Photography Consent 

Our school likes to celebrate your child’s work and achievements. As a result, images of your child and  his/her work may appear on our website, facebook page, twitter or in school publications.  

I _________________________ grant permission to Castletownshend N.S. to take and use photographs  digital images of my child for use in printed publications or materials, electronic publications, school  website, facebook and classroom displays for the duration of his/her time in the school.  

OR 

I __________________________ do not grant permission to Castletownshend N.S. to take and use  photographs digital images of my child for use in printed publications or materials, electronic publications,  school website, facebook and classroom displays for the duration of his/her time in the school.  

Learning Support 

Do you give permission for your child to participate in educational screening tests and to attend learning  support if necessary. Yes / No ……………………………………………………………………………. 

I understand that the classroom support provided to all children in the school by the SEN team includes in  class support, withdrawal of small groups or individual support. 

Conduct: 

I agree that, on enrolment, my child undertakes and is obliged to obey all rules and regulations, whether  written or oral, issued by the school authorities including attached Code of Discipline and the School Ethos. 

Signature of Parent/ Guardian :…………………………………… 

__________________________________________________________________________________ Information requested for the Department of Education and Skills Primary Online Database (POD)  Please see information for Parents note on POD. 

The following two questions are considered sensitive data categories under the Data Protection  legislation therefore it is necessary for each parent to identify their child’s religion and ethnic  background and to consent for this information to be transferred to the Department of Education  and Skills Primary Online Database. 

1. To which ethnic or cultural background group does your child belong? (Please tick one) Categories are taken from the Census of Population 

White Irish _____ Irish Traveller: _______ Roma _______ 

Any other White Background ___________ 

Black African ________ Any other Black Background ___________ 

Chinese _____________ Any other Asian Background ___________ 

Other (including mixed background) ___________ 

No consent ____________

2. What is your child’s religion? 

Roman Catholic _________ Church of Ireland ( including Protestant) ________ Presbyterian __________ Methodist, Wesleyan __________ 

Jewish _____________ Muslim (Islamic) _____________ 

Orthodox (Greek, Russian, Coptic) ______________ 

Buddhist: ________ Jehovah’s Witness: ____________ 

Lutheran: _________ Atheist: _____________ 

Baptist: _________ Agnostic: ____________ 

Other Religions: ________ No Religion: _____________ 

No Consent: ___________ 

I consent for this information to be stored on the Primary Online Database (POD) and transferred to the  Department of Education and Skills and any other primary schools my child may transfer to during the  course of their time in primary school. 

Signed : __________________________ 

Parent / Guardian Date: ____________________________

Castletownshend National School