Kilrickle National School Enrolment Form
Kilrickle,
Loughrea,
Co. Galway
Roll No 16293H
Email kilricklens@gmail.com
Website: www.kilricklens.org
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Childs Details
Child's Forename (as per birth cert) *
Child's Surname (as per birth cert) *
Child's Date of Birth: *
MM
/
DD
/
YYYY
Home Address *
Address Eircode *
Child's PPS Number *
Gender *
Required
Nationality: *
Language Spoken at Home: *
Religon: *
Parental Details
Mother's Name *
Father's Name *
Mother's Maiden Name *
Home Telephone Number *
Mother's Mobile Number *
Mother's Work Contact Number
Mother's Email Address *
Father's Mobile Number *
Father's Work Contact Number
Father's Email Address *
Is your child living with both parents?
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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) *
Please give names & contact number of the people who have permission to receive correspondence about your child (if different from above)
Please give address of the people who have permission to receive correspondence about your child (if different from above)
Please give names and phone numbers of the people who may collect your child from school (if different from above)
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