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Holy Family N.S.

Application for Enrolment Form


__________________________________________________
Name: __________________________________________ Male

Female

Address_:____________________________________________________________
PPSN: ____________________

Nationality of Pupil: ___________________

Fathers Nationality: ________________Mothers Nationality: _______________


Date of Birth: _________________________ Position in Family (1st, 2nd, etc.)
Mothers Name: _______________________Occupation:____________________
Fathers Name: _________________________Occupation:___________________
Home telephone no._:__________________________________________________
Mobiles: Father_____________________Mother ___________________________
Fathers Work No.:_______________Mothers Work No.: ___________________
Names of two other people who can be contacted in an emergency situation:
Name:

Phone No. :

Name: ________________________Phone No.:____________________________


Religion: __________________Parish of Residence: _______________________
Permission to transfer pupils details to relevant agencies: Yes

No

Last school/Playschool attended: ________________________Phone No.________


Relevant medical information (asthma, allergies, epilepsy, etc.)

Family Doctor: ______________________________Phone No.:_______________


____________________________________________________________________

FOR OFFICE USE ONLY


Application Recd._:__________________Registration_No._:__________________
For_Class_:__________________________________________________________
1st_Date_on_Roll_:____________________________________________________
Notes:

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