Child's Surname

Child's Forenames


Date of Birth



 

Address



Home Telephone Number


Proposed Date of Entry
(Sep / Jan / Easter ..Year?)


 

Mother's Name

Mother's Occupation

Contact/Mobile Number

E Mail Address

 Father's Name

Father's Occupation

Contact/Mobile Number

E Mail Address

Schools Attended and Dates(including playschool)

List Other Siblings Ages

Please provide details of were you heard of Drumnigh School

 

Any special educational/developmental requirements?

Why have you chosen Montessori?

 

SECTION 2 - HEALTH DETAILS

 

What is the state of your childs health?

Has your child had any of the following?

Scarlet Fever Mumps Measles German measles

Chicken Pox Whooping Cough None

Details of Vaccinations:

5 in 1 BCG Men C MMR hiB Booster None of these

Other (Please Specify)

Does your child suffer from any allergies? Yes No

Please give details

Any other details which it is felt should be stated

Emergency Contact Name(s) and Numbers(s)

Date

Please note:

1. Children must be 3 or within 8 weeks of being 3 to enroll as students in Drumnigh
2. It is essential that children attending Drumnigh are toilet trained.
3. Children who have attended previous schools (or playschools) will need a report from their previous school.
4. A place is offered a term before the Childs is due to start. At this stage a copy of the Childs Birth Certificate and €280 as a holding deposit is required to secure a place. This is deducted from the yearly school fee.