Foirm Iarratais / Application Form

Foirm Iarratais / Application Form
Ainm / Student Name

First NameLast Name
Contact Email
example@example.com
Seoladh / Address

Street Address

Street Address Line 2

CityCounty

Eircode
Cúrsa

Bus fee included in price, 20% off brochure price if payment made before 15th May 2026
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Cúrsa A - Full Board
28/06/2026 - 11/07/2026

€795.00 Quantity



Cúrsa B - Full Board
12/07/2026 - 26/07/2026

€795.00 Quantity



Cúrsa A - Scoláiri lae (lón san aireamh) Day students, lunch included
€350.00 Quantity



Cúrsa B - Scoláiri lae (lón san aireamh) Day students, lunch included
€350.00 Quantity



Total

€0.00
Gender

Other
Student date of Birth

DayMonthYear
Date
Parent's / Guardian's Name

First NameLast Name
Parent's / Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name of School attending
Has the student any health problems?
Please attach all relevant details
I authorise the college to allow my child to take paracetamol under supervision if required
Dietary requirements:
Name of person who will accept responsibility of above student in Parents/guardian's absense

First NameLast Name
Telephone number of person who will accept responsibility of above student in Parents/guardian's absense
Please enter a valid phone number.Format: (000) 000-0000.
Name of one friend who you wish to be accomodated with

First NameLast Name
Terms and Conditions
After reviewing the policies, please tick if applicable:
Both the student: type students name* and parent: Type parents name* agree this form has been completed to the best of their ability
Date of application

DayMonthYear
Date
Please pay a deposit of €100 to secure your childs place

Bank transfer:

NAME: Coláiste Chara
IBAN: IE07 AIBK9373 O428 165005
BIC: AIBKIE2D

Cheques/Bank Drafts/Postal Orders:

Coláiste Chara
Chill Chartha
Co. Dhún na nGall
Have you paid the deposit?
Should be Empty:

Foirm Iarratais / Application Form

Cúrsa

*

Terms and Conditions