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Gaelscoil Dara - Foirm Chláraithe don Rang Uathachais 2026-2027
Foirm Chláraithe - Rang Speisialta d'Uathachas 
Enrolment Form - Special Class for Autism
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Ainm iomlán an Pháiste/Child's full Name: 
(mar atá ar an teastas breithe/as on birth certificate)
*
Dáta Breithe an Pháiste/Child's Date of Birth:
dd/mm/yyyy
*
Uimhir PPSN an Pháiste/Child's PPSN Number: *
Inscne/Gender: *
Required
Seoladh Baile/ Home Address: *
Éirchód/Eircode: *
Scoil/Naíonra/Suíomh ECCE reatha an pháiste (School/ Preschool/ ECCE setting) *
An raibh fáil ag do pháiste ar thacaíocht bhreise (AIM) i Naíonra nó ar Chuntóir Riachtanais Speisialta (CRS) i mbunscoil roimhe seo?/Has your child received extra support (AIM) in a preschool or had access to a Special Needs Assistant (SNA) in a previous primary school? *
Required
Tuismitheoir/Caomhnóir 1
Parent/Guardian 1
Ainm iomlán/Full name:
*
Uimhir Teagmhála/Contact Number: *
Seoladh Ríomhphoist/Email Address: *
Seoladh, más difriúil ón seoladh thuas: 
Address, if different from above:
 
*
Tuismitheoir/Caomhnóir 2:
Parent/Guardian 2:
Ainm iomlán/Full name:
Uimhir Teagmhála/Contact Number:
Seoladh Ríomhphoist/Email Address:
Seoladh, más difriúil ón seoladh thuas: 
Address, if different from above:
 
Creideamh/Religion:
Náisiúntacht/Nationality: *
Ainm(neacha) siblín(í) atá ag freastal nó a d'fhreastal ar Ghaelscoil Dara (más cuí)/Name(s) of sibling(s) currently attending or who have attended Gaelscoil Dara in the past (if applicable) *
Tuigim gur bunscoil lán-Ghaeilge í Gaelscoil Dara faoi phatrúntacht an Easpaig agus aontaím tacaíocht a thabhairt d'éiteas na scoile/I understand that Gaelscoil Dara is an all-Irish-medium school under the patronage of the Bishop, and I agree to respect and support the ethos of the school: *
Required
Tuigim gur léiriú spéise amháin atá san fhoirm seo do rang speisialta um Neamhord Speictream an Uathachais i nGaelscoil Dara, agus nach ionann í agus tairiscint áite/ I understand that this form is an expression of interest only for a place in the Autism Spectrum Disorder Special Class at Gaelscoil Dara, and does not constitute an offer of a place: *
Required
Deimhním go bhfuil diagnóis ar Neamhord Speictream an Uathachais ag mo pháiste/ I confirm that my child has a diagnosis of Autism Spectrum Disorder: *
Required

Tuigim go mbeidh doiciméadú a dhearbhaíonn incháilitheacht do rang speisialta (m.sh. litir incháilitheachta ón NCSE) ag teastáil chun dul ar aghaidh go céim fhoirmiúil an iontrála/I understand that, in order to proceed to formal application/admission stage, documentation confirming eligibility for a special class (e.g. NCSE letter of eligibility) will be required:


*
Required
Tuigim go ndéantar áiteanna a leithdháileadh de réir Bheartas Iontrála na scoile / I understand that places are allocated in line with with school's Admission Policy: *
Required
Tá litir incháilitheachta ón NCSE ag mo pháiste faoi láthair / Tá sí á fáil/ My child currently has / is in the process of obtaining an NCSE letter of eligibility: *
Required
Síniú/Signature: (Clóscríobh le do thoil/Please type) *
Dáta/Date:
MM
/
DD
/
YYYY
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