Stepaside Educate Together Secondary School Application Form 26/27 (2nd

Stepaside Educate Together Secondary School Application Form 26/27 (2nd - 6th year)
Section A Student Information
Student Name

First NameLast Name
Student Address

Address

City

County

Eircode
Date of Birth
Gender
PPSN
Country of birth
Nationality
To which ethnic or cultural background does the above named student belong?
Year to which student wants to join (2nd year, 3rd year etc.)
Current school
Reason for leaving current school
*We may contact the school in connection with your son's/daughter's enrolment
Other schools attended
Name of sibling(s) currently attending SETSS (if applicable)
Section B Parent/Guardian Information
Parent / Guardian 1

First NameLast Name
Relationship to Student
Parent / Guardian 1 E-mail
example@example.com
Parent 1 / Guardian 1 Mobile phone number (Irish number required)
Please enter a valid phone number.Format: (000) 000-0000.
Parent 1 / Guardian 1 Address

Address

City

County

Eircode
Parent 2 / Guardian 2

First NameLast Name
Relationship to student
Parent 2 / Guardian 2 E-mail
example@example.com
Parent / Guardian 2 Mobile phone number (Irish number required)
Please enter a valid phone number.Format: (000) 000-0000.
Parent 2 / Guardian 2 Address

Address

City

County

Eircode
Proof of address

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Section C Education Details

Required for the assessment of individual educational needs.
1. Study of Irish: Does your child have an exemption from studying Irish? If yes, you must attach a copy of the Certificate of Exemption.
Irish Exemption Certificate (if applicable)

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2. Languages - What languages has the student studied? And to what level?
3. Subjects currently being studied:
4. If English is not the student's first language please answer the following question. As per the Common European Framework of Reference (CEFR), which level of English do you think the student has?
5. Access to Resource/Learning Support Hours (Please tick the relevant box): (a) Has the student had a psychological assessment? If 'Yes' please return it with this form
(b) Has the student previously been granted resource teaching hours or learning support?
(c) Has the student had the services of a Additional Needs Assistant?
If the answer to any of the above is 'Yes' please provide details:
6. Do you intend to make an application to a special class? The special class in the school teaches students who have complex educational needs arising from the following diagnosis: Autism Spectrum.
7. Any other concerns/information of relevance?
Recent School Report

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Psychological assessment (if applicable):

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Signature
Please print name
I hereby authorise SETSS to contact and request the relevant school(s) release any Educational Reports and IEPs/PLPs held in respect of my child.
Please note:

Submission of an application form for enrolment is not a guarantee of a place in Stepaside Educate Together Secondary School (see Admissions Policy)

The information requested on the application form is required in order to process your application for admission to the school.

It is the responsibility of the Parent/Guardian to inform Stepaside Educate Together Secondary School of any change of address, phone number, email address or other relevant information that may occur after the submission of this form.

Please take care when filling out this form as offers of places in the school will be based on the information provided.
Should be Empty:

Stepaside Educate Together Secondary School Application Form 26/27 (2nd - 6th year)

Section A Student Information

Section B Parent/Guardian Information

Section C Education Details