Enrolment form

Thank you for choosing Mercy Primary School Galway for your child’s early education.

We look forward to welcoming you into our school. Please complete the online enrolment form below and a member of our team will come back to you shortly.

Alternatively, download the enrolment form. Please print and complete the form in full and return to the school. If you have any questions, please don’t hesitate to contact us on 091-566452.

Download the form here

"*" indicates required fields

Step 1 of 8

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Child’s information

First Name*

First

Date of Birth*

Last Name*

Last

Nationality*

Birth Certificate First Name*

Birth Certificate First Name

Religion*

Birth Certificate Last Name*

Birth Certificate First Name

Ethnic or Cultural Background*

Please Select From Below

Place of Baptism (if applicable)

PPS Number

Mother's Birth Surname*

Last

Class Applied For*

Please Select From Below

Male/Female*

Male

Female

Start Date*

Home Phone Number*

Upload documentation

Passport Photo

Max. file size: 50 MB.

Birth Certificate

Max. file size: 50 MB.

Please Provide Copy of Baptismal Cert

Max. file size: 50 MB.

EDUCATION HISTORY

Child Resides With*

Both Parents

Mother

Father

Guardian

Number of Children In Family*

Placing of Child (1st, 2nd, etc.)*

Language Spoken at Home*

Date of Arrival in Ireland*

Name & Class of Siblings Already in the School*

Current Address

Street Address Address Line 2 City County Eircode Country

Mobile Number for 'Text-A-Parent/Guardian'*

Home Phone No*

Other Information (eg. allergies, medication or any additional needs)*

Education history

Name & Address of Pre-School or Previous School Attended*

Street Address Address Line 2 City County Eircode Country

Class in Previous School*

Mother's information

First Name*

Mother’s First Name

Last Name*

Last

Mother's Nationality*

Mother's Occupation*

Mobile Number*

Work Number*

Email*

Father's information

First Name*

Father’s First Name

Last Name*

Last

Father's Nationality*

Father's Occupation*

Mobile Number*

Work Number*

Email*

Medical information

Medical & Allergy Information*

Emergency Contact Sequence (e.g. mum, then dad, etc.)*

Doctor's Name*

Doctor's Phone Number*

Emergency Contact Name (if parents/guardians not available)*

Description (e.g. grandparent etc.)*

Mobile Number*

Emergency Contact Name (if parents/guardians not available)*

Description: (e.g. grandparent etc.)*

Mobile Number*

Has Your Child Any Allergies*

Yes

Please Give Details

Does Your Child Appear to Have Any Difficulties with the Following*

Hearing

Speech

Vision

No Difficulties

Please Give Details

Has Your Child Ever Had Any Type of Assessment*

Yes

Please Give Details

Please attach a copy of all assessments relating to your child's development and/or needs

Drop files here or

Max. file size: 50 MB.

You are asked the questions below to help us ascertain your child's needs as we may be able to subsidise trips/books/activities etc.

Are you a medical card holder?*

Yes

Do you receive social welfare other than children's allowance?*

Yes

Do you give permission for your child to go on school trips under teacher supervision during the school day?*

Yes

Do you give permission for your child’s photo/video to be used on our school website and social media sites?*

Yes

Sometimes journalists visit our school to take pictures of the children e.g awards/prizes, sporting events, first day at school etc. Do you give permission for your child to be photographed for school projects, local newspapers, and school related activities?*

Yes

Sometimes the school is requested to pass on names of children and their addresses to the Health Board for immunisation purposes, to secondary schools when children are transferring to second level, to sporting bodies when children are taking part in games outside the school. Do you allow the school to pass on this information to these three bodies?*

Yes

I give permission for my child

To participate in all aspects of the curriculum including the Stay Safe Programme and RSE*

Yes

To receive any necessary support teaching (e.g. language/learning support, etc.)*

Yes

I consent to have records relating to my child (e.g. School Reports, Psychologist Reports, Assessment Test Results and any other relevant information) passed to such other school in which s(he) is enrolled for the future*

Yes

I consent to all relevant information pertaining to my child to be stored on the Department of Education and Skills Pupils On-line Database (POD)*

Yes

Do you consent to your child attending services in a church?*

Yes

To enter school competitions and for their name & date of birth to be shared with the organisers*

Yes

To use the ICT Equipment in the school in line with our ICT Usage Policy*

Yes

To receive any medical attention deemed necessary and to be taken to hospital in case of serious illness or accident*

Yes

Submit enrolment form

The information I have given in this form is accurate*

Yes

Print Name*

Post Custom Field

Submit

Enrolment form

Thank you for choosing Mercy Primary School Galway for your child’s early education.

We look forward to welcoming you into our school. Please complete the online enrolment form below and a member of our team will come back to you shortly.

Alternatively, download the enrolment form. Please print and complete the form in full and return to the school. If you have any questions, please don’t hesitate to contact us on 091-566452.

Child’s information

Upload documentation

EDUCATION HISTORY

Education history

Mother's information

Father's information

Medical information

You are asked the questions below to help us ascertain your child's needs as we may be able to subsidise trips/books/activities etc.

I give permission for my child

Submit enrolment form

CONTACT US

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