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Registration of Interest Form

St. Raphaela's Primary School is a Catholic Girls' school serving the children of the Kilmacud / Stillorgan area with classes from Junior Infants to Sixth Class.

Please include any information you feel relevant to your child's educational experience or learning profile within the 'Note' section.

** Note: the submission of a Registration of Interest form, or the supporting documents requested, does not confer enrolment within a given class or year.***

Child

First name:* Last name:* Gender:* PPS Number:* Date of birth:* Previous school:* Note:* Relgion: Class Level requested: * Please tick to declare that your consent is provided to securely store your child’s personal data, submitted by you, in the school’s Management Information System: Aladdin. (Aladdin is a secure software service application of Cloudware Ltd. (T/A Aladdin Schools). Data submitted will only be processed for the purpose of admission/enrolment: * Name of Previous School or Pre-School Setting: * Name of Sibling (if any) within the school: Is the application being made for a child of a past pupil?: * If your child is the daughter of a past pupil, please provide the mother's name and dates of attendance::

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Family

Home phone number:* Alt home phone number: Address (with Eircode):* Alternate address:

Mother / Guardian

First name:* Last name:* Email:* Mobile number:*

Father / Guardian