Saint Paul's Primary School

Saint Paul's Primary School
Borris Road
Portlaoise

Phone :(057) 8621132
Fax: (057) 8662494

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Principal: Mr. Desmond Sutton

Student First Name: ___________________________

Surname:____________________________________

Gender: M ___ F____

Date of Birth:__________________________
Present Class:___________________________
Address:_______________________________
_______________________________
______________________________________
Previous School:___________________
__________________________________
__________________________________

PPS Number:__________________________
(required for all students)

Students resides with:_______________________________
Nationality: _________________ Religion:_____________________


Family Details


Father’s Name:______________________________
Nationality:__________________________
Occupation:______________________________

Mother’s Name:__________________________
Nationality:__________________________
Occupation:_________________________

Address:____________________________
____________________________________
____________________________________
Phone No. (Home)____________________
(Work)____________________

Address: ____________________________
____________________________________
____________________________________
Phone No. (Home)____________________
(Work) ___________________

Other Contact(s) e.g. neighbour, granny etc (specify details __________________________________
Note: it is essential that we have contact number in case of medical or other emergencies.
If you change address or phone number please let us know as soon as possible



Total number of children in family:

Position of this Student
Details of Brother/Sister in this school now:

Doctor’s Name: _________________

Phone No: __________________

Has your child suffer from any allergies:________________

If Yes please specify_________________________________________________

__________________________________________________________________


Educational Details:
If Moving from another school please give additional details:

Full Name of School ____________________

Name of Principal__________________

Address______________________________

_______________________________

________________________________

School Phone Number_______________________

Note: Please submit Report from previous school

Does your child require any special academic help? Yes No



Has this Student been assessed for such needs? ___________________________________________________________

Please give details(Please attach copy of reports)

_________________________________________________________________________________________


IRISH: If your child was exempt from Irish. If you believe your child should be exempted please outline the reasons below and attach document to support your case,

______________________________________________________________________________


PLEASE SUBMIT THE FOLLOWING WITH THIS APPLICATION
2 SIGNED PASSPORT PHOTOGRAPHS
A COPY OF STUDENTS BIRTH CERTIFICATE
ANY RELEVANT EDUCATIONAL/PSYCHOLOGICAL REPORTS (IF APPLICABLE)

Mother’s Signature; ______________________

Father’s Signature; ______________________

Other Signature; Other Signature
____________________________ ______________________________


Date:…………………………………….