<p> STAR OF THE SEA B.N.S., Leahy’s Terrace, Sandymount, Dublin 4</p><p>Email: [email protected] Principal: Kevin Munnelly Phone: (01) 6686394</p><p>ENROLMENT APPLICATION FORM FOR SEPTEMBER 2018 Application forms must be received by the School before January 12th 2018 </p><p>Child’s Name (as on Birth Certificate) ………………………………………………PPSN…………………...... </p><p>Date of Birth………………………… Nationality of child …………………………Religion…………………………..…… While Star of the Sea is a school with a Catholic ethos, it also has due recognition for all other religions</p><p>Date of child’s arrival in Ireland (if applicable)…………………………Email address…………………………………….. Please print Language spoken at home (e.g. Irish/English) ...... </p><p>Home Address …………………………………………………………………………………………………………………..</p><p>School previously attended (if applicable)…………………………………Previous Class…………………………………</p><p>Father’s Name …………………………… Nationality…………………………… Phone No…………………………</p><p>Mother’s Name …………………………… Nationality…………………………… Phone No…………………………</p><p>Child’s Position in family…………………………. Names of Brother/s…………………………………………</p><p>MEDICAL HISTORY Vaccinations & Immunisations …………………………………………………………………………………………</p><p>Fears & Anxieties ………………………………… Allergies …………………………………………………</p><p>At times it will be necessary to forward your son’s details to the HSE for purposes of inoculation, hearing tests, dentist etc., To consent please sign here ………..…………………………………………….</p><p>Any other relevant information e.g. Medical reports/ Speech & Language reports/ Educational Assessments/ Specialists reports etc.,</p><p>If yes, please give details………………………………………………………………………………………………</p><p>……………………………………………………………………………………………………………………………</p><p>Custody Issues: In the case of a custody dispute who has legal rights to collect your child from school?</p><p>………………………………………………………………………………………………………………………… ***INCOMPLETE APPLICATIONS WILL NOT RECEIVE A LETTER OF ACKNOWLEDGEMENT FROM THE SCHOOL AND CANNOT BE PROCESSED***</p><p>Our Enrolment Policy is on our website – www.starofthesea.ie. A copy of this is also available from the Secretary’s office on request. Please read the following carefully and then tick the boxes as appropriate.</p><p>I have read and understood the school Enrolment Policy. </p><p>I include with this application a copy of my child’s; Birth Certificate </p><p>Baptismal Certificate (if Catholic)</p><p>I understand that it is my responsibility to ensure that the school receives a completed application form with all requested Certificates before the closing date for applications, and that in the event of a dispute, only a letter of acknowledgement from the school will be accepted as proof of having applied.</p><p>Parent’s/ Guardian’s signature…………………………………………………..Date……………………………… </p>