You are in: Further Education Courses  -  Application Process 

Application Form

Course Title:


PPS / RSI Number:
Surname:
First Name:
Gender:
Male      Female
Full Postal Address:
Home Telephone:
Mobile:
Email Address (if any):
Date of Birth:
Nationality:
Present or Last School:
School Roll Number: (available from school)
Please Indicate Type of School:
 Vocational       Community       Secondary
Present Course:
 Leaving Certificate       Other
Examinations already taken:
 Leaving Certificate
Year Taken:
Please Indicate Type of School:
 Vocational       Community       Secondary
Are you currently enrolled in an Irish School?
 Yes       No
Please indicate your position on 30th September last:
 Kylemore College (U) Other School (V)
 In Training (Y) Left School
 Employed (X) Other (Z)
How many years have you spent in 2nd level school?

Are you currently undertaking an ESF funded course? (e.g. VPT/PLC)
 Yes       No
Have you applied for any other PLC course at Kylemore College?
 Yes       No
Do you consider yourself to have a Disability?
 Yes       No
If yes, please give brief details.
Supplementary Information: Please give brief details of interests or experience relevant to your application.
How did you hear about this course?
For students over 18:
I consent to the information contained in this application form being notified to the Department of Education and Science as part of the annual pupil enrolment returns.
 Yes
Date:
For students under 18:
I consent to my son/daughter's information contained in this application form being notified to the Department of Education and Science as part of the annual pupil enrolment returns.
 Yes
Date:
Please enter the security code below in the text box. CAPTCHA Image