Rmds Pre-Enrolment Application Form Page 4
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4RMDS PRE-ENROLMENT APPLICATION FORM
PLEASE COMPLETE PART A IN BLOCK CAPITALS AND RETURN TO:
THE ENROLMENT SECRETARY, RMDS, RANELAGH ROAD, DUBLIN 6
All siblings must be enrolled on separate forms
PART A
Details of Child
NAME ______________________________________________________________
EXPECTED YEAR OF ENTRY: _____________ CLASS REQUIRED __________________
GENDER: _________________ DATE OF BIRTH: ___________________
□
□
Does your child have special needs?
Yes
No
If so, please give details: ________________________________________________
_____________________________________________________________________
Please note that you should inform the school a.s.a.p. if this changes so that we can ensure your
child’s needs are met.
Contact details for Parents(s)/Guardian(s)
Name……………………………………..........................
Name……………………….........................……………..
Address………………………………….........................
Address……………………….....…….……....................
………………………………………………........................
…………………………………………......……...................
Telephone (home) ………………………..................
Telephone (home) ………………………...................
(mobile) ………………………..................................
(mobile) ………...............………………....................
E-mail address ……………………………...................
E-mail address ………………………….…...................
Signed: ___________________________________ Date: ___________________
If you wish to receive an acknowledgement you MUST also complete PART B and return the
completed form together with a stamped addressed envelope.
School Use Only:
Date of receipt: __________________
Pre-enrolment Reference:_____________
-------------------------------------------------------------------------------------------------------------------------------------
The Enrolment Secretary needs to know of any change of address in writing.
Please note that the onus is on you to ensure that the school has your current address.
PART B
NAME OF CHILD: __________________________ ____
DATE OF BIRTH: _______________
School Use Only:
PRE-ENROLMENT REFERENCE: __________
DATE OF ISSUE: __________
SIGNED: ________________________________________
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