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Enrolment
Ballinahinch National School - Enrolment Application Form
Ballinahinch NS
Ballinahinch, Birdhill, Co. Tipperary
Roll number:
17296S
School Patron: Dr. Kieran O’Reilly
Phone:
061-379404
Email:
[email protected]
Pupil’s Name
*
First
Last
Date of Birth
*
Day
Month
Year
Pupil's PPS Number
*
Gender
*
Male
Female
Address (at which the applicant resides)
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Parish in which the applicant resides
Any medical issues/Medical History
Does your child have siblings who are attending the school ?
*
Please choose
Yes
No
Name and class of Sibling(s) currently enrolled
Parent(s)/Guardian(s) Details:
Name
*
First
Last
Relationship
*
Parent
Custodian
Legal Guardian
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email Address
*
Enter Email
Confirm Email
Mobile Number
*
Home Number
PARENT(S)/GUARDIAN(S) DETAILS:
Name
*
First
Last
Relationship
*
Parent
Custodian
Legal Guardian
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email Address
*
Enter Email
Confirm Email
Mobile No.
*
Home No.
Signature 1 (Please type your first and last name)
*
First
Last
Date
*
DD slash MM slash YYYY
Signature 2 (Please type your first and last name)
*
First
Last
Date
*
DD slash MM slash YYYY
**Please note completion of this form does not guarantee enrolment. Your request for enrolment will be considered and the school will be in contact with you regarding further documentation that may be required in accordance with the school Admissions Policy
Data received on this form will be stored on our electronic system and used for school purposes only.
Completed enrolment applications must be returned to Ballinahinch NS, Ballinahinch, Birdhill, Co. Tipperary no later than closing time on closing date.
Name
This field is for validation purposes and should be left unchanged.
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