Ballincollig Early Years Pre-school Application

Office Use Only

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PARENT/GUARDIAN USE:

This form to be filled out by the Named Parent/Guardian who is registering the child and to whom all correspondence will be sent.

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CHILD DETAILS

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PARENT(S) / GUARDIAN(S) CONTACT DETAILS

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PERSONAL DETAILS

Does your child have any medical conditions, chronic or acute?

Is your child currently under the care of a Health Care Professional for any reason?

Does your child have any illness which would need additional support from the Pre-school?

Does your child have any special needs which would need additional support from the Pre-school?

Does your child have any specific dietary requirements which would need additional support from the Pre-school?

Have any of your child's siblings/relations attended Ballincollig Early Years Pre-school in the past? If Yes, please provide names and details

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SESSION INFORMATION

Which session would be preferred? (Please tick relevant box).  Please note for the 2018/19 year, we will operate a pre ECCE (2 yrs to 2 yrs 8 mths) in the afternoon session Room 1. There will be no morning pre ECCE session.

Do you wish to be contacted if a place in either session becomes available or would you rather wait for your preference? Please tick.

Your child's name will go on a Waiting list as soon as this Application Form is received. However this does not guarantee a place. (See Enrolment Policy). Please state whether you are looking for a place immediately or for a specific time. Please tick one.