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Kilrickle National School Enrolment Form
Kilrickle,
Loughrea,
Co. Galway
Roll No 16293H
Email
kilricklens@gmail.com
Website:
www.kilricklens.org
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* Required
Childs Details
Child's Forename (as per birth cert)
*
Your answer
Child's Surname (as per birth cert)
*
Your answer
Child's Date of Birth:
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
Address Eircode
*
Your answer
Child's PPS Number
*
Your answer
Gender
*
Male:
Female:
Required
Nationality:
*
Your answer
Language Spoken at Home:
*
Your answer
Religon:
*
Your answer
Parental Details
Mother's Name
*
Your answer
Father's Name
*
Your answer
Mother's Maiden Name
*
Your answer
Home Telephone Number
*
Your answer
Mother's Mobile Number
*
Your answer
Mother's Work Contact Number
Your answer
Mother's Email Address
*
Your answer
Father's Mobile Number
*
Your answer
Father's Work Contact Number
Your answer
Father's Email Address
*
Your answer
Is your child living with both parents?
Yes
No
Other:
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Is there a court order or specific custody or access arrangments in place that the school must be informed of? (If yes please provide copies to the school)
*
Yes
No
Other:
Please give names & contact number of the people who have permission to receive correspondence about your child (if different from above)
Your answer
Please give address of the people who have permission to receive correspondence about your child (if different from above)
Your answer
Please give names and phone numbers of the people who may collect your child from school (if different from above)
Your answer
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