Please enable JavaScript in your browser to complete this form. - Step 1 of 5Cuid 1: Sonraí an Pháiste Part 1: Child's DetailsAinm an pháiste(Childs Name) *FirstLastDáta Breithe (Date of Birth) *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Ait sa Teaghlach (Place in Family) *Uimhir Phearsanta Seirbhíse Poiblí (PPSN) *An bhfuil cárta leighis ag do pháiste? (Does your child have a medical card?) *Tá (Yes)Níl (No)Teanga Dhúchais (Native Language)Náisiúntacht (Nationality)Creideamh (Religion If any)Does any Legal Order under Family Law exist that the school should know about? *Tá (Yes)Níl (No)Ba mhaith liom mo pháiste a chlárú sa rang seo a leanas (I wish to enrol my child in the following class)Rang (Class) *Rang (Class)Naíonáin Shóisearacha (Junior Infants)Naíonáin Shinsearacha (Senior Infants)Rang 1 (1st Class)Rang 2 (2nd Class)Rang 3 (3rd Class)Rang 4 (4th class)Rang 5 (5th Class)Rang 6 (6th Class)Tabhair faoi deara: Caithfidh aois 4 bliana a bheith sroichte ag do pháiste roimh/ar an 1ú Meán Fomhair sa bhilain Ina bhfuil spéis agat do pháiste a chlárú sna Naíonáin Shóisearacha. (Your child must have reached their 4th birthday on or before September of the year in which you wish to enrol in Junior Infants.)Birth Certificate File Upload * Click or drag files to this area to upload. You can upload up to 2 files. Recent Picture Of Child * Click or drag files to this area to upload. You can upload up to 2 files. Court Order - (copy of Court order required if such a document exists). *Please attach a copy if the school should know about it for Child Protection Reasons. Click or drag a file to this area to upload. Please attach any additional reports the school should be aware (e.g. speech and language, hearing/ sight, medical conditions such as asthma, epilepsy, heart condition, diabetes, allergies or any relevant report ). Click or drag files to this area to upload. You can upload up to 6 files. Sonraí leighis an pháiste (Child's Medical History)Sonraí Leighis / Medical History *Sonrai maidir le ailéirge, leigheas nó aon fhadhb pearsanta nó tinneas gur chóir don fhoireann teagaisc a bheith ar an eolas fúthú ar mhaithe le leas an pháiste. (e.g. details of medication, allergies, personal difficulties or illness which, to ensure the welfare of the child should be made known to teaching staff) Ainm dochtúra/Guthán (Doctors Name) *Doctors Phone Number *Ainm Fiaclóra/Guthán (Dentist's Name) *Dentist Phone Number *Glacaim leis go mbeidh leagan Gaeilge ainm mo pháiste in úsáid (I understand and accept that the Irish version of my child's first and last name will be used in all communication) *Tá (Yes)Cuir an leagan GaeiIge de shloinne do pháiste ar fáil le do thoil I (mas eol duit) (Please provide the Irish version of your child's surname (if known)Síniú Tuismitheora/Caomhnóra (Parent/Guardian Signature) *Clear SignaturePlease use your mouse or touchscreen phone to sign the form.NextCuid 2: Sonraí Tuismitheora/Caomhnóra (Part 2: Parent/Guardian Details)Máthair (Mother)Ainm (Mothers Name)Slí Bheatha (Mothers Occupation)Seoladh agus Cód Poist (Mothers Address and Eir Code)Address Line 1CityState / Province / RegionPostal CodeUimhir Baile (Mothers Home Phone Number)Uimhir Fón Poca (Mothers Mobile Number)Athair (Father)Ainm (Fathers Name)Slí Bheatha (Fathers Occupation)Seoladh agus Cód Poist (Fathers Address and Eircode)Address Line 1CityState / Province / RegionPostal CodeUimhir Baile (Fathers Home Phone Number)Uimhir Fón Poca (Fathers Mobile Number)PreviousNextCuid 3: Liosta Teagmhála Part 3: Contact ListSa gcás nach bhfuil tuismitheoirí ar fail Please provide the details of as many people as possible below. We will only ever contact people from this list if we cannot make contact with the parent first. Ainm (Contact 1)Ról i saol an pháiste (e.g aunt, uncle, family friend etc.)Ulmhir teagmhalaAinm (Contact2)Ról i saol an pháiste (e.g aunt, uncle, friend etc.)Ulmhir teagmhala Ainm (Contact 3)Ról i saol an pháiste (e.g aunt, uncle, family friend etc.)Ulmhir teagmhala Ainm (Contact 4)Ról i saol an pháiste (e.g aunt, uncle, family friend etc.)Ulmhir teagmhalaAinm (Contact 5)Ról i saol an pháiste (e.g aunt, uncle, family friend etc.)Ulmhir teagmhalaAinm (Contact 6)Ról i saol an pháiste (e.g aunt, uncle, family friend etc.)Ulmhir teagmhala (Contact Number)PreviousNextCuid 4: Foirm Cheadaithe ( Part 4: Permission Form)1. Going on school tours, local educational visits/field trips and participating in school activities (e.g. sports day, matches, quizzes, choir, Féile na hinse etc) *YesNo2. On occasions local press photographers take group photos of children and in some instances identify the children by name. Do you agree to the school using your child's image in this way? *YesNo(Please remember that removing a child from a photo of the rest of the class can be quite upsetting for the child)3. Sometimes the school is given the opportunity to participate in radio and television programmes e.g. RnaG or TG4. DO you wish to grant your child permission to participate in these events? *YesNo4. Can we use your child's name (not photo) in relation to publicising school events and activities in our newsletter, website and similar publications? *YesNo5. It is the school's policy to celebrate your child's work and achievements. As a result images of your child and his/her work may appear on our website. Best practice will always be followed. Usually children will only be pictured at a distance and in groups. Do you agree to the school using your child's mage in this way? *YesNo6. Most classes have an extra support teacher assigned to help all children in the class. Usually, for organisational reasons the learning support teacher works with groups or individual children (If your child is experiencing learning difficulties you will be informed personally by the teacher.) Do you agree? *YesNo7. All schools are required by Department of Education and Skills to cover Stay Safe Programme in its entirety. Parents are required to confirm that they have been made aware of this. *YesNo8. Do you give permission for your child to be treated and/or taken immediately to a doctor or hospital in case of serious illness/accident? *YesNo9. On occasion we administer 'Diagnostic' tests (e.g Neale Analysis, MIST, Belfield Infant Screening, NRIT) to discover the educational progress of pupils Should any concerns arise following these tests we will contact you. Do you aqree to this? *YesNo10. Health Service Executive request information from schools in relation to details of children’s contact details and class level, date of birth etc. for the purpose of organising health screening appointments. Do you consent for your details to be shared in this way ? (choosing not to share details with HSE means that you will not be contacted about the option of Health Screening offered to primary school children e.g. hearing/ sight tests etc. ) *YesNoName of Child *FirstLastParents/Guardian Email *EmailConfirm EmailI/we wish to enrol our child as a pupil of Gaelscoil na bhFilí. We will cooperate with the staff and support the ethos of the school. Parents/Guardian Signature *Clear SignaturePlease use your mouse or touchscreen phone to sign the form.PreviousNextCuid 5: Bunachar Sonrai Ar Line do Bhunscoileanna (POD) Part 4: Primary Online Database (POD) (copy)What is POD? The Primary Online Database (POD) is a nationwide individualised database of primary school pupils, facilitating the monitoring of educational progress as pupils move through the primary education system and on to post primary. The system allows schools to make online returns to the Department of Education and Skills (DES) and provides the Department with the comprehensive and in-depth information needed to develop and evaluate educational policy What is it used for? • Completion of the National School Annual Census — As of September 2016 POD is the mechanism for schools to complete the Annual Census • Teacher allocation and payment of capitation and other grants — Information submitted through the Annual Census forms the basis for teacher allocation, capitation and grant payments for each school Resource allocation and planning purposes • Statistical Information- POD is the source of statistical information for the primary school sector • Register of pupils — PO has removed the need for schools to maintain a hardcopy of their school's Clarleabhar as all necessary information on is recorded on the system •Centraised updating of school information POD provides a single point for schools to view and correct the details held by the Department What information is recorded on POD? The following information is collected for each pupil on POD: For this section it is up to the Parent/Guardian if you consent for the below information in Part 5 to be shared with Department of Education and Skills.Do you consent for the below information to be shared with Department of Education and Skills *YesNoPersonal Information: PPSN Name Birth Certificate Name (if different from above) Date Of Birth Gender Mother's Birth Surname Address (Including Eircode) County of Residence Nationality Mother Tongue* Irish Exemption (if any)* *Pupils in Mainstream Schools Only *Pupils in Special Classes Only *Pupils in Special Schools Only Enrolment Information Standard (ie Junior Infants First Class etc) Teacher/Class Name Enrolment Source Enrolment Date Leaving Date Leaving Destination Pupil Type Class Type** Integrated Indicator** Category of Capitation*** Second Level Programme* *Pupils in Mainstream Schools Only *Pupils in Special Classes Only *Pupils in Special Schools OnlyThere are also two optional fields of data on POD. As these are considered sensitive personal information under the Data Protection Acts, they can only be recorded on POD with the explicit written consent of the pupil's parent(s) or guardian(s) The fields are as follows •Religion (Aggregated information on religion will be used for statistical purposes only) •Ethnic or Cultural Background (Aggregated information on Ethnic/Cultural background will be used to track the progress of these groups and to compare their progress with other groups thereby identifying gaps in the system and assisting in the developments and implementation of appropriate policies and interventions) In order to assist with the gathering of data please complete page one and two of this form. This form will be retained by the school POD - Rang (Class) *Rang (Class)Naíonáin Shóisearacha (Junior Infants)Naíonáin Shinsearacha (Senior Infants)Rang 1 (1st Class)Rang 2 (2nd Class)Rang 3 (3rd Class)Rang 4 (4th class)Rang 5 (5th Class)Rang 6 (6th Class)Special ClassPOD - Pupil Name *FirstLastPOD - PPSN of Pupil *POD - Pupil's Date of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920POD - Pupil's GenderMaleFemalePOD -Birth Certificate Forename (if different from above)POD - Birth Certificate Surname (if different from above)POD - Mother's Maiden Surname *POD - Pupils Address & Eircode - Nationality (in the case of dual citizenship where Irish is one, please choose Irish)Address Line 1Address Line 2CityState / Province / RegionPostal CodePOD - Optional Information - To which ethnic or cultural background does your child belong?White IrishIrish TravellerRomaAny other white background Black or Black Irish-AfricanBlack or Black Irish-any other backgroundAsian or Asian Irish -ChineseAsian or Asian Irish-Any other Asian backgroundOther (including mixed background)No consentWhat is your child's religion?Roman CatholicChurch of Ireland (including Presbyterian Protestant)PresbyterianMethodist, WesleyenJewishMuslim (Islamic)Orthodox (Greek, Coptic, Russian)Apostolic or PentescostalHinduBuddhistJehovah's WitnessLutheranAtheistBaptistAgnosticOther ReligionsNo ReligionNo ConsentI consent for the sensitive personal data in the two questions above (i.e Optional Information and Religion) to be stored in the Primary Online Database (POD) and transferred to the Department of Education and Skills and any other primary schools my child may transfer to during the course of their time in Primary School.POD - Siniú Tuismitheora/Caomhnóra (Parent/Guardian Signature) *Clear SignaturePlease use your mouse or touchscreen phone to sign the form.PreviousSubmit
