Fill in the form below, then submit to the school or download / print for your records.
Child Details
Medical Conditions and Allergies
Does your child have any specific medical conditions (e.g. asthma, eyesight, hearing) or emotional difficulties that may affect them at school?
It is the responsibility of parents and guardians to notify the school of any food allergies.
Does your child have an allergic reaction to any medication or food?
Additional Details
The following fields are optional but help the school maintain accurate records.
Preschool History
Did your child attend preschool?
Has your child ever received a speech and language report?
Has your child ever had a psychological assessment?
School History
Did a parent or guardian of your child attend this school?
Did your child previously attend a primary school?
Siblings
Does your child have a sibling currently enrolled in the school (including step/foster siblings' resident at the same address)?
Has a sibling of your child previously attended this school (including step/foster siblings' resident at the same address)?
Parent / Guardian 1 Details
If two parent / guardians, please complete the following section:
Parent / Guardian 2 Details
Emergency Contacts
Family Doctor
By signing below, I/we declare that the information provided in this application is accurate and complete to the best of my/our knowledge, and I/we consent to this information being processed by Modeligo National School for enrolment purposes in accordance with the school's Privacy Policy. I/we acknowledge that this electronic signature has the same legal standing as a handwritten signature under the EU eIDAS Regulation (No 910/2014).
Sign in the box below using your mouse, finger, or stylus
If two parent / guardians, please also sign below:
Sign in the box below using your mouse, finger, or stylus