Enrolment Form 2021/22

* Indicates required field

Child's Name *

First

Last

Middle name *

Gender *

PPSN: *

Your child's proposed class *

Date of Birth *

Place of Birth: *

Child's Nationality (please select) *

Child's Nationality (Please state country/countries) *

Child's ethnic/cultural background (optional) *

No. of years in Ireland *

Name and location of current school/creche *

Religion (optional) *

Current school/creche setting *

Telephone no. of current school/creche *

Permission to contact current school/creche *

Siblings presently in school *

If yes, please state name and class *

Parent 1/Mother *

First

Last

Parent 2/Father *

First

Last

Parent 1 Relationship to child *

Parent 2 Relationship to child *

Parent 1 Phone No. *

Parent 2 Phone No. *

Parent 1 Contact Email *

Parent 2 Contact Email *

Parent 1 Address *

Parent 2 Address (if different to Parent 1) *

EIRCODE *

Parent 2 EIRCODE (if different to Parent 1) *

Is one of the child's mother tongues (ie language spoken at home) Irish or English? *

List any medical conditions/allergies your child has *

Does your child have special educations needs, LS/EAL? *

Please nominate one person who, in the event of an emergency, can reach the school within 10 minutes. Name/Relationship to Child/Mobile *

Please tick *

I agree to familiarise myself with all school policies which can be found on the school website, hansfieldetns.com.

Please tick *

I agree with the school's policy on positive behaviour.

Please tick *

I agree with the school's policy on first aid administration.

Please tick *

I permit my child to be taken on occasional school educational excursions, eg sports, swimming

Please tick *

I permit HETNS to give my contact details to the HSE for the purpose of free medical checks provided during my child's years in primary school.

Please tick *

I permit HETNS to pass on details on this form to statutory bodies when required.

Signed (your name) *

Date *

Submit