First Year Admission Application Form Getting Started 2019/20

First Year Admission Application 2020/21 Getting Started!
Section A: Student Information
Student Name*
First NameLast Name
Does your child have an existing sibling attending the school?*
Sibling 1 Full Name
Sibling 2 Full Name
Sibling 3 Full Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Date of Birth*
DayMonthYear

Section B: Parent/ Guardian Information
Parent 1 / Legal Guardian 1 Name*
First NameLast Name
Birth Surname (if different)
Relationship to student
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
E-mail*
Phone Number*
Area CodePhone Number
Home Phone Number
Area CodePhone Number
Parent 2 / Legal Guardian 2 Name
First NameLast Name
Birth Surname (if different)
Relationship to student
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
E-mail
Phone Number
Area CodePhone Number
Home Phone Number
Area CodePhone Number
In cases where the student's parents/ guardians do not live together, please identify which category describes the custody arrangements for your child. (Where sole custody has been granted by a court, proof of the same must be supplied to the school, when requested).
Joint custodySole custodyNot applicable
Please explain any additional custody arrangements here, if applicable.
Emergency contact details*
Contact1 Contact 2
Name
Contact number
Relationship to student
Please indicate name and address of person to whom correspondence is to be sent regarding educational progress/attainment of the student, if different from details outlined in Section 2 above *
Parent/guardian
Name
Contact number
Relationship to student

	Parent/guardian
Name
Contact number
Relationship to student

	Please tick one only
a. The student lived outside the country until 11 years of age
b. The student is re-enrolling in a state school having spent at least three years abroad and is at least 11 years of age
c. The student has a psychological report recommending exemption from the study of Irish. The assessment has been carried out within the last three years. (In this case the school will require a copy of this report)

	Doctor's details
Doctor's name
Address of practice
Phone number

Section E: School Vision and Policies
Under the patronage of Educate Together, Firhouse ETSS is a restorative school that is values-based, committed to building relationships, responding to conflict in a healthy way and, connecting us to our best selves and to each other.
We are committed to:
- Restorative Practice and living our RESPECT values (Relationships / Empathy / Safety / Personal Accountability / Equity / Community / Trust)
- Fostering student voice and whole-school community engagement
- Realising principles of equality, social justice, democracy and sustainability
- Using a cross-curricular and team-teaching approach whenever possible
- Using digital technology and a virtual learning environment to create, communicate, store and distribute teaching and learning materials
- Using a combination of formative and summative assessment methods that support student learning and assess knowledge, skills, understanding and values
Please tick one box*
Yes No
I/We am/are happy for my/our child to be enrolled in such a learning environment
Section F: Consent Form for Sensitive Personal Data for the School’s October Return to the Department of Education and Skills
Certain sensitive personal data which the Department asks post-primary schools to furnish via the “Annual Post-Primary School October Return/Examination Entries” process requires your written consent for your child’s school to record this information and for the school to forward this information to the Department for purposes as outlined in circular 0047/2010, a copy which is available at www.education.ie or on request from the school.
Please tick one box for each question*
Yes No
1. Do you or your child possess a medical card?
2. Is your child a member of the Traveller Community?
“Traveller Community” means the community of people who are commonly called Travellers and who are identified (both by themselves and others) as people with a shared history, culture and traditions including, historically, a nomadic way of life on the island of Ireland. Section 2(1) of the Equal Status Act, 2000.
This particular information will be retained by the post-primary school and will be made available for inspection by authorised officers of the Department or from the Office of the Data Protection Commissioner.

	Yes	No
I/We am/are happy for my/our child to be enrolled in such a learning environment

Section G: Permissions
Photographs, Digital Images and Recordings of Students
The school will maintain a database of photographs and recorded images of school events held over the years. It is customary to take photos and recorded images of students engaged in activities and events in the interest of creating a pictorial as well as a historical record of life at the school. Photographs and recorded images may be published on our school website, school social media account(s) or in brochures, newsletters, local and national newspapers, and similar school-related productions. Photographs, digital images and recordings may also be used for teaching, learning and assessment purposes.

Research and Teacher Continuing Professional Development (CPD)
From time to time, the school may be involved in research projects (including research with external agencies) and activities to support Teacher CPD that will help develop educational research, teacher practice and potentially the learning experience in our school and elsewhere. Students may be asked to contribute to such research and activities in the form of quantitative and qualitative data as well as projects, photographs, digital images and recordings.

Please tick one box*

	Yes	No
I agree that my child’s photograph may be used for the purposes outlined above
I agree that my child’s photograph may be taken for school administration
I agree that my child may be involved in research and activities for the purposes outlined above

Workshops and Field Trips
Over the time of their educational journey with Firhouse ETSS, your child will have the opportunity to attend and participate in events such as:
- Workshops from guest speakers, theatre groups and educational programmes
- Trips out of school designed to enhance learning, inform around educational opportunities, employment possibilities, team building, self-care, health and wellbeing
- Sporting activities, and other activities where they represent the school.
This list is not exhaustive.
By granting permission, students in Firhouse Educate Together Secondary School can partake in workshops and field trips. The permission applies to all workshops and field trips occurring within the school year.
Parents will be notified in advance of field trips, outings or school-related activities. At that time, parents will have the option to withdraw permission for any individual outing, trip or activity by contacting the school. If you choose not to sign this annual permission form, you will be asked to give permission for your child to participate in each field trip throughout the school years.
Field trips may require transportation to a location away from the school campus. As a parent or guardian, it is essential to understand that the school and staff will try to prevent accidents. However, some activities on field trips involve inherent risks to students regardless of all feasible safety measures that may be taken by the school. Parents must agree to accept responsibility for any loss, damage or injury to their child that occurs during their child’s participation in any given field trip that is not the result of fraud, wilful injury to a person or property, or the wilful or negligent violation of the law by a member, trustee, employee, or agent of Firhouse ETSS.
In the event it becomes necessary for school staff in charge to obtain emergency care for your child, neither he/she nor the school assumes direct financial liability for expenses incurred because of an accident, injury, illness and/or unforeseen circumstances. Firhouse ETSS employees or volunteers in charge of the students are authorised to obtain all necessary emergency medical care and authorise any licensed physician and/or medical personnel to render necessary emergency treatment for your child.
Please tick one box*
Yes No
I/we grant permission for my/our child to participate in workshops and field trips, as outlined above.

	Yes	No
I/we grant permission for my/our child to participate in workshops and field trips, as outlined above.

Allergies*
Yes no
Does your child have any allergies which the teacher should be aware of before going on a school outing, trip or activity?
If so, please list allergies (e.g. peanut allergy)
If so, please describe allergy symptoms/treatment (i.e. EpiPen, etc.)
Other Medical Conditions*
Yes No
Does your child have another medical conditions which the teacher should be aware of before going on a Field Trip?
If so, please list medical condition(s) (e.g. Asthma)
If so, please describe any symptoms/treatments
Section H: Administration of Assessment Instruments to Students
During your child’s education in Firhouse ETSS, s/he will have the opportunity to engage in a wide range of assessment activities as part of normal teaching and learning. Other specialist tests may also be administered to support your child’s educational development and learning as well as his/her career development. Such tests may include achievement, ability, diagnostic and interest tests.
There may also be occasion to administer tests on an individual basis to your child to support his/her learning, progress and achievement. Such tests will only be administered following consultation with parents. If you would like to find out more please do not hesitate to contact the school.
Please tick one box*
Yes No
I give consent for assessment instruments to be administered to my son/daughter whilst a student of Firhouse ETSS.

	Yes	no
Does your child have any allergies which the teacher should be aware of before going on a school outing, trip or activity?

	Yes	No
Does your child have another medical conditions which the teacher should be aware of before going on a Field Trip?

	Yes	No
I give consent for assessment instruments to be administered to my son/daughter whilst a student of Firhouse ETSS.

Section I: Security and notes
Form completed by:*
Date
MonthDayYear
Time
:HourMinutesAM/PM Option
Please note:
1. For admission to the school in September 2020, students must have reached the age of 12 years on January 1st 2021.
2. Submission of an application form for enrolment is not a guarantee of a place in Firhouse Educate Together Secondary School (see Admissions Policy).
3. Should a first round offer be made to parents/guardians, they must complete the registration process within 14 days of that offer being made. Failure to respond within 14 days will result in the child’s place in the school being forfeited.
4. Should a second or subsequent round offer be made to parents/guardians, they must complete the registration process within 7 days of that offer being made. Failure to respond within 7 days will result in the child’s place in the school being forfeited.
4. It is the responsibility of parents/guardians to inform Firhouse Educate Together Secondary School of any changes of address, contact details or other relevant information that may occur after submission of this form.
5. The School’s Admissions Policy is available on the Enrolment 2020 page of our website, www.firhouseetss.ie.
Enter the message as it's shown*
I understand, in submitting this form, the information may be made available to the Department of Education and Skills (DES) in order to plan for school development.

Should be Empty:

	Yes	No
a) Has the student had a psychological assessment?
b) If the answer to (a) above is ‘Yes’ is the psychological report available?
c) Has the student been granted resource teaching hours by the National Council for Special Education (NCSE)?
d) Has the student had the services of a Special Needs Assistant (SNA) granted by the NCSE?
e) Has the student had learning support at Primary School?

	Yes	No
Do you have a Medical Card?
Does the student require glasses?
Does the student have any hearing difficulties?

First Year Admission Application 2020/21 Getting Started!

Section A: Student Information

Section B: Parent/ Guardian Information

Section C: Educational Details

Section D: Medical Details

Section E: School Vision and Policies

Section F: Consent Form for Sensitive Personal Data for the School’s October Return to the Department of Education and Skills

Section G: Permissions

Section H: Administration of Assessment Instruments to Students

Section I: Security and notes

	Yes	No
1. Do you or your child possess a medical card?
2. Is your child a member of the Traveller Community?

	Yes	No
Asthma
Diabetes
Epilepsy
Anaphylaxis
Cystic Fibrosis
Other