GRENNAN COLLEGE, LADYWELL, THOMASTOWN, Co. KILKENNY Enrolment Form: September 20_____ All details on this form are required to enrol the student with the Department of Education and Skills. Please affix a copy of any exemptions granted to your child from the Department to this form before returning it to the school. Please read very carefully and complete this form correctly. Student Details: Student Surname: Student Forename: (as on Birth Certificate) Student Address: Date of Birth: Sex: Male/Female Religion: PPS Number: Medical Card Holder: Country of Birth: Please mark yes or no Y/N Correspondence to: (give the title(s) to which all letters home should be addressed, i.e. Mr & Mrs. If you live with one parent/guardian please give the preferred title i.e., Mr. , Mrs. or Ms. and correct surname. Mother/Guardian’s First Name and Present Father/Guardian’s Name: Surname: Mothers Maiden Name: Address: Address: Daytime contact phone no. Home: Mobile: Email: Daytime contact phone no. Home: Mobile: Email: (please state the name of contact i.e. name of workplace) (please state the name of contact i.e. name of workplace) Doctor’s Name: Address: Tel. No.: If your child has any illness or is on medication please specify: Any Disability or Special Educational Needs: (if yes, please supply all reports/assessments) Any brothers/sisters in the school? If yes, please state their name and year/class group: Distance from School: Method of Travel to School: Name of Primary School attended/attending: Name of school principal: Class at Present: Is your son/daughter exempt from Irish? Y / N (if yes, please submit a copy of the exemption letter) Are you in receipt of resource hours? Y / N (if yes, how many hours per week?) _______ Have you a report from an Educational Psychologist? (if yes, please submit a copy) If you have any difficulty completing this form please contact Grennan College at 056 7724112 Each new student will need to present a copy of their Birth Certificate in September, this can be obtained from the Births, Deaths & Marriages Registration, James’ Green, Kilkenny if the birth was registered in Kilkenny. All information provided will be treated with the utmost confidentiality. Please return this form to the Office at Grennan College immediately.