Dromclough National School, Listowel
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Phone: 068-40293
Email: dromc@eircom.net
www.dromcloughns.com
 
Reg. Charity Number: 20124052

 

Picture

​Dromclough N.S.,
Listowel,
Co. Kerry.
​V31 W640

​Roll No: 19957A

APPLICATION RE.  ENROLMENT  2022:   Junior Infants only
 
 
Pupil's Full Name :__________________________________________(as on birth cert) PPS No:________________ 
A copy of child's Birth Certificate must accompany this form & will be retained in the school file.      
A copy of child’s Baptismal Certificate (if applicable) for the receiving of the sacraments of First Holy Communion & Confirmation.
 
Christian Name by which child is known :_____________________________ Place in Family:__________________
 
Date of Birth : __________________ Nationality: ______________Church (or Parish) of Baptism:_______________
 
Address :__________________________________________________________________ Eircode: ____________
 
Mothers Mobile No:______________________________ Father’s Mobile No:­________________________________
 
Email addresses:  Mother:________________________________   Father:_________________________________
 
Mother's Maiden Name :_____________________________  Father's Name:________________________________                                                               
 
Mobile No. for text-a-parent___________________________
 
Any previous schools attended :___________________________________________________ Class:____________
 
Pre-school attended:_____________________________________________________________________________
 
Name of Family Doctor :__________________________________________________________________________
Your child may be brought to Doctor or hospital in the event of emergency.
 
Does your child have any medical condition(s)?  _______ If Yes, please identify _____________________________
 
Any other important information? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 
Is your child on any long-term medication? Y/N. . . . . . . . . If Yes, specify . .. . . . . . . . . . . . . . . . . . . . . .  . . . . .
 
Has child attended the Brothers of Charity, Enable, KIDS or any other disability services :   Yes   {    }      No    {    }
 
If Yes, Please give details: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . . . . . . . . . . . . . .  **
 
Has your child attended a Speech & Language or Occupational Therapist? Y/N_____ Where/Whom?_____________
 
Names & ages of any younger brothers & sisters: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 
N.B.  Persons who may be contacted if child becomes ill at school and parents are unavailable :-
 
Name :___________________________________          Name :__________________________________________
 
Address :__________________________________         Address :________________________________________
 
Phone No:_________________________________         Phone No:_______________________________________
 
If any details on this form should need to be updated or changed during your child's attendance at school please notify the Principal.
Acceptance for enrolment requires that parents and pupils accept and comply with school policies.
 
Signature of Parent/Legal Guardian:__________________________________________ Date :_________________
Please return, with certificates, by Thurs. 9th Dec. 2021.
** If required, continue overleaf or on a second sheet.

©2013 Dromclough National School, Listowel, Co. Kerry - Sponsored and maintained by The Dromclough NS Parents Association