Application for Enrolment in

Castledockrell N.S.
Phone No: 053-9388892
E-mail: castledockrellns@eircom.net
Website: castledockrellns.weebly.com

Ar Aghaidh le Chile

Pupils First Name:

Pupils Address:

Pupils Surname:
Birth Cert Name:
(if different from above)

PPS No.:
Name of Parent(s) \ Guardian(s):

Date of Birth:
Mothers Maiden Name:

Address of Parent(s) \ Guardian(s):

Nationality:

Telephone Number(s):

Daytime Number(s):

Name of Emergency Contact:

Emergency No.:

Parent(s)
occupation(s):
Does any legal order under
family law exist that the school
should know about? Please give
details.
Name and address of
previous primary school:
(if applicable)
Reason for transferring:
(if applicable)
Religion:

Church where pupil was baptised:

(if applicable)
Please attach copy of Birth Certificate and Baptismal Certificate (if applicable)
Name of Doctor:
Address:

Tel No:
In the event of a serious illness/accident involving my child (if I cannot be
contacted) I give permission for him/her to be brought to his/her doctor or
hospital.
(Please tick)

If your child suffers from any allergy, disability or long term illness which you feel
the school should be aware of please specify below.
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
Please indicate below if your child has been assessed in any of the following areas.
If so, please furnish the school with a copy of same, at your earliest convenience.
Please tick.
Educational Assessment
Psychological Assessment
Psychiatric Assessment

Signed: __________________________ Date: _______________________

Signed:__________________________ Date:_______________________

Please be assured that all information on this form is private and confidential.
Parent(s) will need to keep the school up to date with personal details, for
example, address, next of kin, etc. Some of this data may be kept on
computer and some will be forwarded to the Department of Education.
The BOM Castledockrell N.S. will inform you in writing within 21 days of their
decision concerning this application for enrolment.

Section 2 of the Data Protection Act 1988 provides that:

A Data controller or processor shall, as respects personal data kept by him, comply with the
following provisions:
Data shall only be kept for one or more specified and lawful purposes.
Data shall not be used or disclosed in any manner incompatible with that purpose or those
purposes.
Data shall be adequate, relevant and not excessive in relation to that purpose or those
purposes and shall not be kept for longer than is necessary for that purpose or those
purposes.
Appropriate security measures shall be taken against unauthorized access to, or alteration,
disclosure or destruction of, the data and against their accidental loss or destruction.