St. Michael's National School Enrolment Form
This is an application for admission of new pupils in September 2021.
Name of Child *
Birth Certificate Name (if different name to above)
Gender *
Home Address *
Eircode *
Date of Birth (D.O.B) *
Nationality *
Child's Personal Public Service (PPS) number *
Relevant school information (e.g. pupil attendance, progress etc.) to be shared with.. *
Father's Name *
Mother's Name *
Mother's Maiden Name *
Mother's/Father's Address if different
Mother's Contact Number (Please include Mobile, Home and Work Numbers) *
Mother's Email Address *
Father's Contact Number (Please include Mobile, Home and Work Numbers) *
Father's Email Address *
Other Contact Numbers
Name(s) of Brothers/Sisters in the School
Family Doctor Name and Contact Number *
Please make us aware of any Health Problems (asthma, allergies, hearing, eyesight etc.) and if any medication is required. Please note ALL medications will be kept in the General Office.
Medical Card Holder *
How will your child be travelling from school? NOTE: Please inform the school by letter if your child is travelling on the bus. *
Name of nominated person (s) to collect your child from school and contact number.
Has your child been assessed by a Speech and Language Therapist? *
Has your child any problems with speech and language? *
Is your child receiving the services of a Speech and Language Therapist? *
Do you have a Speech and Language Report? If yes, please supply the school with a copy of the report. *
Does your child attend Enable Ireland? *
If you answered yes to the previous question, please state for what service, e.g. Speech & Language, Occupational Therapy, Physiotherapy? Please supply the school with a copy of the report.
Name of Child's Playschool
Any other relevant information about your child
What is your child's religion? *
Place of Baptism NOTE: Please supply the school with a copy of your child's birth certificate and baptismal certificate.
To which ethnic or cultural background group does your child belong (please tick one)?(Categories are taken from the Census of population) *
If previously in attendance at another national school, please give the following details. Name of School, School Address, Period spent in attendance, Class in which your child was enrolled at the date of leaving.
Any other relevant information on the child.
I agree to cooperate with the staff and support the ethos of the school. *
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