CLÁRÚ – Signup 2018 – Gaeilge gan Eagla

Gnéas / Gender*
- Buachaill
- Cailín
Roghnaigh Cúrsa / Choose Course*
The waiting list for Cúrsa A is oversubscribed. Meanwhile, cúrsaí B & C are excellent options for 2nd year students. Between 30-40% of these courses are typically 2nd year students. The fact that these courses have a higher average age leads to a more mature learning environment and therefore, in our opinion, a more productive cúrsa Gaeilge. Thankfully, applying for cúrsaí B & C is a more relaxed process as these courses fill over a period of a few months as opposed to a few hours for cúrsa A.
- Cúrsa A 02/06/2018 - 24/06/2018
- Cúrsa B 25/06/2018 - 17/07/2018
- Cúrsa C 18/07/2018 - 09/08/2018
- Cúrsa D 10/08/2018 - 25/08/2018
Current School Year*
- Bliain 1
- Bliain 2
Current School Year*
- Bliain 1
- Bliain 2
- Bliain 3
- Idirbhliain
- Bliain 5
Current School Year*
- Bliain 1
- Bliain 2
- Bliain 3
- Idirbhliain
- Bliain 5
Current School Year*
- Idirbhliain
- Bliain 5

Ainm / Name*
Ainm Baiste / First Name Sloinne / Surname
Dáta Breithe / Date Of Birth*

DD
MM
YYYY
Scoil / School*
Please provide your full postal address
Seoladh 1 / 1st line of address*
Seoladh 2 / 2nd line of address*
Seoladh 3 / 3rd line of address
Seoladh 4 / 4th line of address
Parental / Guardian Email*
This will be the primary channel of communication. Please ensure that you submit a current & active email address.
Enter Email Confirm Email
Primary Parental / Guardian Mobile Phone Contact*
Note: Relevant text messages will be forwarded to this number.
Students can avail of an optional return bus travel (from Baile Átha Cliath, Cill Bheagáin, Portlaoise, Áth Luain) at an extra cost of €50. This is paid along with the balance of fees in April/May 2018.
Return travel required*
- Yes
- No
If yes, choose location*
- Baile Átha Cliath
- Portlaoise
- Cill Bheagán (Kilbeggan)
- Áth Luain

Deposit Payment
We need to receive, by post, a signed (Parent/Guardian) application form along with a €200 (€50 non-refundable) deposit in order to process an application. Print the completed application form, signed and confirm your payment details as outlined below. You will be able to download a copy of the application form on submission.
Method Of Payment*
- By Cheque / Money Order
- Bank Transfer
Clearly indicate the name of student / course name (A/B/C or D) along with the students date of birth on the back of the cheque / money order being forwarded along with signed application form
The narrative used for transaction needs to match your application. We suggest that you the following format when writing narrative - the first two letters of child’s first name along with first two letters of surname followed by course choice (A/B/C or D) followed by date of birth dd/mm/yy.
For example: Seán O’Brien / Cúrsa C / 4th June 2002 - SeO’BrA040602
This is essential to confirm payment. Please duplicate the narrative for bank transfer on application form.
Account Name: Coláiste Lurgan.
BIC: AIBKIE2D
IBAN: IE73AIBK93740100915353

_________________________________________
Please write Bank Transfer narrative here once printed
Note: The following Section is to be signed and returned once you submit and download the form.
Language Behaviour Condition
I understand that my child's language behaviour is a significant factor while attending the Cúrsa Gaeilge and that it is a clear condition of enrolment that (s)he uses the Gaeilge (s)he has at all times while conversing with fellowstudents.

_________________________________________
Parental/ Guardian Signature

I fully intend to use Gaeilge in all my conversations, including private & personal exchanges, with my fellow students during the cúrsa Gaeilge.

_________________________________________
Student's Signature
Accommodation Arrangements
To request to be accommodated with a friend (max three friends), applications will need to be forwarded in the same envelope.
Forwarding Address
Forward this application with €200 deposit to:

Coláiste Lurgan,
Indreabhán,
Co. na Gaillimhe.

Make cheques payable to Coláiste Lurgan.
Phone
This field is for validation purposes and should be left unchanged.

Step 1 of 4

Deposit Payment

Note: The following Section is to be signed and returned once you submit and download the form.

Language Behaviour Condition

Accommodation Arrangements

Forwarding Address