Section 29 Appeals Board - Exclusion Appeal Form

Exclusion Appeal Form

Appellant's Details

Sonraí an Achomharcóra

Step 1 of 5

Céim 1 de 5

Appellant's First Name Céadainm an Achomharcóra*

Appellant's Surname Sloinne an Achomharcóra*

Title Teideal*

Address Seoladh*

Eircode Éirchód*

County Contae*

Telephone Number Uimhir Ghutháin

Mobile Phone Number Uimhir Fón Póca*

E-mail Address Seoladh Ríomhphoist*

Email is the preferred method of this Department’s communication therefore, please ensure your email details are correct Is é ríomhphost an rogha modh cumarsáide na Roinne seo, cinntigh mar sin go bhfuil do shonraí ríomhphoist i gceart

Confirm E-mail Address Deimhniú Seoladh Ríomhphoist*

Relationship To Student Gaol leis an Dalta*

Please tick this box if you have suitable and reliable broadband internet connection and you would prefer your hearing by video conferencing instead of face to face? Cuir tic sa bhosca seo má tá nasc idirlín leathanbhanda oiriúnach iontaofa agat agus go mb’fhearr leat go dtarlódh do éisteacht trí fhíschomhdháil seachas duine le duine?

Student's Details

Sonraí an Dalta

Step 2 of 5

Céim 2 de 5

Student's Full Name Ainm Iomlán an Dalta*

Student's Date of Birth Dáta Breithe an Dalta*

Sex of Student Inscne an Dalta

Student's Address Seoladh an Dalta

Special Educational Needs Riachtanais Speisialta Oideachais

Special Educational Needs Details Sonraí Riachtanais Speisialta Oideachais

School Details

Sonraí Scoile

Step 3 of 5

Céim 3 de 5

Class or School Year Rang nó Scoilbhliain*

Year/class of student Bliain/rang an dalta

Educational Setting Suíomh Oideachais

School Scoil*

Appeal Details

Sonraí Achomhairc

Step 4 of 5

Céim 4 de 5

Appeal Type Cineál Achomhairc*

Date of Suspension Confirmation Dáta ar Fionraí Díbeartha*

Enter Date of Suspension Confirmation (for multiple suspensions with a cumulative of 20 school days or more in a school year, this is the last confirmed suspension date). I gcás fionraí iolracha le móriomlán de 20 lá scoile nó níos mó sa scoilbhliain, is é seo an dáta deimhnithe deiridh ar fhionraí.

Cumulative Suspension Days Laethanta Fionraí Carnach

Enter the total number of suspension days, the period(s) of suspension must total 20 school days or more in a school year. Ní mór 20 lá scoile nó níos mó a bheith mar mhór-iomlán laethanta fionraí, an tréimhse/na tréimhsí fionraíochta i scoilbhliain.

Grounds of Appeal Grounds of Appeal*

Documentation

Cáipéisí Tacaíochta

Step 5 of 5

Céim 5 de 5

You may upload up to files.
Accepted file formats are .
Max file size is MB.

Is féidir leat suas le chomhad a uaslódáil.
Formáidí comhaid a nglactar leo
Uasmhéid comhaid MB

This browser is not supported.
Use a newer browser to be able to upload files.

Níl tacaíocht leis an mbrabhsálaí seo .
Bain úsáid as brabhsálaí níos nuaí le bheith in ann comhaid a uaslódáil.

Summary

Réamhamharc ar Iarratas

Preview

Appellant's Details

Sonraí an Achomharcóra

Title Teideal	Not Entered Gan scríofa
First Name Céadainm	Not Entered Gan scríofa
Surname Sloinne	Not Entered Gan scríofa
Address Seoladh	Not Entered Gan scríofa
County Contae	Not Entered Gan scríofa
Phone Uimhir Ghutháin	Not Entered Gan scríofa
Mobile No Uimhir Fón Póca	Not Entered Gan scríofa
E-mail address Seoladh Ríomhphost	Not Entered Gan scríofa
Relationship To Student Gaol leis an Dalta	Not Entered Gan scríofa

Student's Details

Full Name Céadainm	Not Entered Gan scríofa
Date of birth Dáta Breithe	Not Entered Gan scríofa
Sex Inscne an Dalta	Not Entered Gan scríofa
Address Address	Not Entered Gan scríofa
Special Educational Needs Riachtanais Speisialta Oideachais	Not Entered Gan scríofa
Special Educational Needs Details Sonraí Riachtanais Speisialta Oideachais	Not Entered Gan scríofa

School Details

Sonraí Scoile

Class / Year Rang nó Scoilbhliain	Not Entered Gan scríofa
Educational Setting Suíomh Oideachais	Not Entered Gan scríofa
School Name Scoil	Not Entered Gan scríofa
School Roll Number School Roll Number	Not Entered Gan scríofa

Appeal Details

Sonraí Achomhairc

Appeal Type Cineál Achomhairc	Not Entered Gan scríofa
Date of Notification of Intention to Expel Dáta an Fhógra ar Chinneadh Díbeartha	Not Entered Gan scríofa
Date of Suspension Confirmation Dáta ar Fionraí Díbeartha	Not Entered Gan scríofa
Date of Expulsion Confirmation Dáta ar Dheimhniú Díbeartha	Not Entered Gan scríofa
Cumulative Suspension Days Laethanta Fionraí Carnach	Not Entered Gan scríofa
Grounds of Appeal Cineál Achomhairc	Not Entered Gan scríofa

Documentation

* required fields * ag teastáil

Roll # Roll #		Name Name
Level Level		Address Address IE

Section 29 Appeals

Achomhairc Alt 29

Section 29 Appeals

Achomhairc Alt 29

Exclusion Appeal Form

Exclusion Appeal Form

Appellant's Details

Sonraí an Achomharcóra

Student's Details

Sonraí an Dalta

School Details

Sonraí Scoile

Appeal Details

Sonraí Achomhairc

Documentation

Cáipéisí Tacaíochta

Summary

Réamhamharc ar Iarratas

Appellant's Details

Sonraí an Achomharcóra

Student's Details

Student's Details

School Details

Sonraí Scoile

Appeal Details

Sonraí Achomhairc

Documentation

Documentation