Kilkenny College, Castlecomer Road, Kilkenny, Ireland

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Application Form

PLEASE PRINT THIS APPLICATION FORM

Return the form to:

KILKENNY COLLEGE
CASTLECOMER ROAD
KILKENNY
IRELAND

TELEPHONE: 353-56-7761544
FAX: 353-56-7765779
E-MAIL: info@kilkennycollege.ie

APPLICATION FORM
NAME OF PUPIL ____________________________________

PROPOSED DATE OF ENTRY ____________________________________

IF NOT ENTERING FORM 1 YEAR STATE, WHICH FORM

THE PUPIL WILL ENTER ON THE DATE ABOVE ____________

IS APPLICATION FOR A DAY OR BOARDING PLACE ____________

Please complete this form using BLOCK CAPITALS and return to The Headmaster. Submission of the Application Form does not guarantee a place. Pupils are selected in accordance with the Kilkenny College Admissions Policy (enclosed). The closing date for receipt of applications is 30th September prior to the year of entry.

Surname of pupil ____________________________________________________________

First name(s) ____________________________________________________________

Name by which pupil is generally known ___________________________________________

Date of Birth __________________ Sex (Male/Female) ____________________

Pupil’s PPS No. __________________ Nationality __________________________

(Available from the Dep’t of Social & Family Affairs)

Religious denomination of pupil ___________________________________________________

Pupil is a member of which parish _________________________________________________

Pupil’s current school ___________________________________________________________

Details of brothers and sisters

Name Date of Birth Kilkenny College Pupil (Former/current/proposed)

_____________________________________________________________________________

Home Address ________________________________________________________________

_____________________________________________________________________________

Home Telephone No. ___________________________________________________________

Address of second parent (state which) if different from home address _____________________

______________________________________________________________________________

Details of Father/Guardian Details of Mother/Guardian
Full Name ___________________________ Full Name ___________________________

Occupation __________________________ Occupation __________________________

Daytime contact no. ___________________ Daytime contact no. ____________________

Mobile phone no. _____________________ Mobile phone no. ______________________

Email address ________________________ Email address ________________________

Religious denomination ________________ Religious denomination _________________

Year left Kilkenny College _____________ Year left Kilkenny College ______________
(if applicable) (if applicable)

If parents live at separate addresses please state who is to receive;

Fee invoice ____________________________________________________________________

School reports __________________________________________________________________

General school correspondence _____________________________________________________

If the pupil has any disability or special educational needs please state them below including information about support measures which have already been provided. Please enclose all relevant documentation such as medical or educational psychological reports, details of resource hours in operation from the Department of Education and Science at primary or secondary level. Please be assured that this information does not affect entry to the school. It is essential to us as in the secondary system, special needs support from the DES is given only in response to our requests based on the needs of our current pupils.

______________________________________________________________________________

Information for Parents
A separate Application Form must be completed for each child. This blank form should be printed off for each child. The application should be fully completed and returned to the school office with photocopies of the pupil’s birth certificate or passport, one passport photo, all relevant medical or specialist reports plus at least two recent reports from the pupil’s current school. If applying for a place in a Year other than First year please provide either a written reference from the Principal of the previous school attended or his/her name and telephone number.

Should a place be offered you will be asked to sign an Enrolment Agreement Form and to pay a non-refundable Booking Fee to confirm your acceptance of the offer. Prospective parents should read the Kilkenny College Code of Conduct before accepting a place and paying the Booking Fee.

Signature of Parents of Guardians (both to sign)

In registering this application I/we understand that this does not guarantee a place for entry in Kilkenny College. If accepted for entry I/we undertake for ourselves and for the applicant to observe the rules and regulations of the school. I/we agree to pay all applicable fees by the 15th September (first invoice) and 15th February (second invoice) and I/we also undertake to give a term’s written notice of withdrawal or to pay a term’s fees in lieu of such notice.

Signature Relationship to applicant Date

_________________________ ______________________________ ___________________

_________________________ ______________________________ ____________________

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For Office use only

Date Rec’d ____________________ Contact re I/V ____________________

Ack sent ____________________ Place offered ____________________

Admission no ____________________ FBF Rec’d ____________________

Logged ____________________ PB logged ____________________

HM notes

Kilkenny College, Castlecomer Road, Kilkenny, Ireland - Irish secondary school