Expression of Interest Form

Expression of Interest Form

Please complete this form to register your interest in one of our free Lifelong Learning courses. A member of our team will be in touch soon
This project is funded by SICAP, priority will be given to individuals living in disadvantaged areas, head of one parent households or those who are long term unemployed.
Do you live in South Dublin County?*

YesNo
Please select the programme you wish to register your interest for If the programme is no longer on the list. There are no more places available*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you currently unemployed? (For Career Preparation course only)

YesNo
How long are you unemployed (For career preparation only)
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
School Name: (Work Placement only)
School Year
Age Band*
Unfortunately, we only work with people living in South Dublin County.

For contact details to the Partnership that operates in your area please consult the listing HERE.
Referral Org ID*
Ref
Should be Empty: