An Edmund Rice School. APPLICATION FORM FOR ADMISSION TO. MOUNT SION PRIMARY SCHOOL. (PRIVATE AND CONFIDENTIAL). Mount Sion Primary School is entitled to be supplied with all relevant information. All information given must be true and accurate and will

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Mount Sion Primary School

An Edmund Rice School

Barrack Street, Waterford City

Roll No: 19947U

Phone: 051-377947

Email: office@mountsionprimaryschool. ie

APPLICATION FORM FOR ADMISSION TO

MOUNT SION PRIMARY SCHOOL

(PRIVATE AND CONFIDENTIAL)

Mount Sion Primary School is entitled to be supplied with all relevant information. All information given must be true and accurate and will be treated in a strictly confidential manner. False or misleading information will lead to disqualification of the application.

PUPIL’S DETAILS

Child’s First Name: _________________________________________Child’s Surname: ______________________________________

Child’s Date of Birth: ______________________________________ Child’s PPS No: ______________________________________

Child’s Main Address(this address will be used for correspondence on application process and must be current): _______________________________________________________________________________________________________________________________

Religion: Please state religion if any___________________________________________________________________________________

DETAILS of PARENTS/GUARDIANS

1. Full Name: ______________________________________________ _____________________________________________

Please state relationship to applicant.

Contact details of parent/guardian at 1. Above: Phone: _______________________________________________________

Email: _______________________________________________________

2. Full Name: ______________________________________________ _____________________________________________

Please state relationship to applicant.

Contact details of parent/guardian at 2. Above: Phone: _______________________________________________________

Email: _______________________________________________________

Please answer the following questions as the information offered may be used to determine the allocation of places in the event of oversubscription:

1. Does the applicant have a brother currently enrolled in Mount Sion Primary School? Yes No

If Yes, pleasestate brother’s name and class:

Brother’s name: _____________________________ Brother’s name: _____________________________

Class: _____________________________ Class: _____________________________

2. Is the applicant a son of a current member of staff of Mount Sion Primary School? YesNo

If Yes, pleasestate staff member’s name: _____________________________________

3. Does the applicant have a brother(s) who attended Mount Sion Primary School? YesNo

If Yes, pleasestate brother’s name: _____________________________________ Years of attendance: ________________

_____________________________________ Years of attendance: ________________

4. Is the applicant a son of a past pupil? YesNo

5. If Yes, pleasestate father’s name: _____________________________________ Years of attendance: ________________

In accordance with section 23(4) of the Education (Welfare) Act 2000, as parent/guardian of the applicant _______________________________ (Please insert child’s name)I/We hereby confirm in writing that the code of behaviour of the school is acceptable to me/us and that I/Wewill make all reasonable efforts to ensure compliance with this code by __________________________(Please insert child’s name).

By signing this application I am also certifying that I am legally entitled to apply for a place for my child at this school and that there is no legal impediment to me making this application.

Signature of parent/guardian:

1. ______________________________________ Date: _________________________

2. ______________________________________ Date: _________________________

The following documentation must be provided:

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