Naíscoil Chloch na gCoillte

 Bóthar Chnoc na Raithni,

Cloch na gCoillte,

Co. Chorcaí.

P85 YV90

http://naiscoilclonakiltypreschool.webador.ie/

naiscoilchlochnagcoillte@hotmail.com 

Guthán: 087 6990424

                                                             FOIRM CHLÁRUCHÁIN         (Please use block letters)

Ainm an Pháiste _______________________________________________________________

Child’s name

Dáta Breithe___________________________________Inscne _________________________

Date of birth                                                                 Gender

Seoladh ______________________________________________________________________

Address ______________________________________________________________________

Ainm an Tuismitheora/Chaomhnóra 1. ___________________________________________

Parent’s /Guardian’s names                  2. ___________________________________________

Guthán ______________________Baile         1.___________________________Guthán Póca

Telephone                                    Home        2.___________________________Mobile

Seoladh Idirlín________________________________________________________________ 

Email address

Blian ag tosnú ar Naíscoil                 Méan Fomhair 20___     Méan Fomhair 20___    

Year starting in the Naíscoil               September (1^st year )     September (2^nd year)

Laethanta ag teastáil

Requested days – please tick

Luan Mon                  __Tráthnóna Afternoon        __Maiden Morning    

Máirt Tues                 __Tráthnóna Afternoon        __Maidin Morning  

Céadaoin Wed          __Tráthnóna Afternoon        __Maidin Morning  

Déardaoin Thurs       __Tráthnóna Afternoon       __Maidin.Morning  

Aoine Fri                     __Tráthnóna Afternoon       __Maidin Morning      

Luigh ainm na bunscoile ar a mbeidh do pháiste ag freastal ______________________________________________________________

Name of Primary School your child will be attending                  Blian Year ________

Taille Airithinte Booking Fee of €100 enclosed                                 __ Yes   __  No

I grant permission for Naiscoil Chloch na gcoillte to retain this information on file for the duration of my child’s attendance in your setting __Yes  __ No

Siniú Tuismitheora ________________________________________ Dáta _______________

Parent’s Signature                                                                             Date