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*
prevnext( X )
Cúrsa A22/06/2025 - 05/07/2025
€595.00 Quantity



Cúrsa B06/07/2025 - 20/07/2025
€595.00 Quantity



Cúrsa A - Scoláiri lae (lón san aireamh) Day students, lunch included
€250.00 Quantity



Cúrsa B - Scoláiri lae (lón san aireamh) Day students, lunch included
€250.00 Quantity



Total

€0.00
Gender*

MaleFemaleOther
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.
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:*

No special needsCoeliacVegetarianNut allergyOther
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.
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
After completing this form, please pay a deposit of €100

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
Should be Empty:

Foirm Iarratais / Application Form

Terms and Conditions