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St. Oliver Plunkett N.S. Blackrock, Co. Louth | +353 42 9321598 | office@blackrockns.ie|Principal Mrs. C. Dempsey & Deputy Principal Mrs. B. Kelly
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Application for Special Classadmin2025-02-24T13:47:22+00:00

Application form for Special Class for Autism

This is an application form ONLY and admission is not guaranteed until the form is processed and a confirmation has been sent by the school.

Childs Details

If you do not want to fill in a field then mark as "NOT APPLICABLE" or "N/A"
Child Name(Required)
DD slash MM slash YYYY

Parents / Guardian - 1 Details

Name(Required)
Please mark as N/A if not available
If you do not have an email - Enter noemail@domain.com
(if different from above)

Parents / Guardian - 2 Details

If you do not want to fill in a field then mark as "NOT APPLICABLE" or "N/A"
Name(Required)
Please mark as N/A if not available
If you do not have an email - Enter noemail@domain.com
(if different from above)

Additional Info

If you do not want to fill in a field then mark as "NOT APPLICABLE" or "N/A"
Please mark as N/A if not applicable

Emergency Info - If different from Parents

If you do not want to fill in a field then mark as "NOT APPLICABLE" or "N/A"
Contact Person Name(Required)

Permissions and Wellbeing

If you do not want to fill in a field then mark as "NOT APPLICABLE" or "N/A"
Do you give permission for your child to be taken directly to hospital in case of serious injury or accident?(Required)
Do you give permission for your child to take part in the R.S.E and Stay Safe programmes?(Required)
See https://www.pdst.ie/staysafeparents
Do you give permission for the school to advise the Department of Education (DES) through the pupil online database (POD) of your childs religion and ethnic/cultural background?(Required)
The above information is collected by the DES for statistical purposed and to gather information on the diversity in the school.
Is there any Legal Order under Family Law that currently exists that the school should be made aware of?(Required)
Document Upload required if answer is "YES"
Max. file size: 20 MB.
Do you give permission for your child to be photographed for school projects, local newspapers and school related activities?(Required)
Do you give permission for your child’s photograph and or work to be used on the schools website?(Required)
Annually the school is asked to provide information to the HSE to facilitate their work regarding immunisations, sight & hearing tests and dental appointments. Do you give permission for your childs details to be made available?(Required)
Does your child attend the Early Intervention services?(Required)
Document Upload required if answer is "YES"
Max. file size: 20 MB.
Has your child ever had a psychological assessment?(Required)
Document Upload required if answer is "YES"
Max. file size: 20 MB.
Has your child ever had a a speech and language assessment?(Required)
Document Upload required if answer is "YES"
Max. file size: 20 MB.
Has your child received a Preliminary Determination of Eligibility to a Special Class Placement letter?(Required)
Document Upload required if answer is "YES"
Max. file size: 20 MB.
eg allergies, epilepsy, diabetes, asthma, fainting, etc
Does your child have any difficulties with hearing?(Required)
Does your child have any difficulties with speech?(Required)
Does your child have any difficulties with vision?(Required)
Does your child have any issues socially or behavioural that the school should know about?(Required)

Documents Upload

Upload documents where available - photo or scanned versions.
Max. file size: 20 MB.
A birth cert is REQUIRED but may be provided in paper or emailed separately.
Consent(Required)
We acknowledge that we have read and accept St. Oliver Plunkett N.S. Code of Behaviour and School Rules. We will co-operate with the staff of St. Oliver Plunkett N.S. and support the ethos of the school. All of the schools policies are available on our website at www.blackrockns.ie

About Us

St. Oliver Plunkett N.S. is a co-educational, Catholic, primary school, which strives to provide a well-ordered, caring, happy and secure atmosphere where the intellectual, spiritual, physical, moral and cultural needs of the pupils are identified and addressed.

Upcoming Events

Dec 19
12:00 pm - 3:00 pm

Christmas Holidays

View Calendar

Contact Info

St. Oliver Plunkett National School, Blackrock, Co. Louth

Phone: 353 42 9321598

Email: office@blackrockns.ie

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