Saint Patrick's B.N.S., Cork.

Enrolment Form:

Please attach a copy of your child's birth and baptismal certificates.

Pupil's Name: _____________________________

Address: _________________________________________________________

Date of Birth: ____________________ Home Tel No: ____________________

Religion: ________________________

Previous School: ___________________________ Class: _______________

Father's Name: _____________________ Occupation: ________________

Mobile No: _________________

Mother's Name: _____________________ Occupation: ________________

Mobile No: _________________

No. of children in family: _______________ Place of child: _______________

Family Doctor: _______________________ Tel: _______________________

Do you hold a medical card? Yes/No

Details of any illness or problem, which may affect your child's school life:
________________________________________________________________

________________________________________________________________


In the event of there being nobody at home we need phone numbers and addresses of relatives/neighbours of your choice who can be contacted:

Name: ________________________ Name: _________________________

Address: ______________________ Address: ________________________

______________________ ________________________

Tel: __________________________ Tel: ____________________________



I give permission for my child to use the internet for educational purposes and I also give permission for my child to be taught the Stay Safe Programme which gives children strategies to help protect themselves from bullies and/or strangers.


Signed: Parent's/Guardian's signature(s):


____________________________ _____________________________