Booking Form 1 - Coláistí Chorca Dhuibhne Irish College

1 Contact Details

2 School Details

3 Parent / Guardian Details

4 Other Details

5 Terms & Conditions

Preparation Course for Leaving Cert Irish Oral - Leaving Cert
X4: 21 November 2020-20 February 2021
| €50 deposit | €250 total
Amount you are paying now: €54 (includes a €4 online booking fee)
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Contact Details
Name*
First Name Surname
Gender*
- Male
- Female
Date of Birth*
Date Format: DD slash MM slash YYYY
Address*
Street Address Address Line 2 City County Postal Code Country
Parent's Email*

Please enter the Parent's email address to receive booking confirmation. Please note that all correspondence will be through e-mail unless otherwise stated.

Preparation Course for Leaving Cert Irish Oral - Leaving Cert
X4: 21 November 2020-20 February 2021
| €50 deposit | €250 total
Amount you are paying now: €54 (includes a €4 online booking fee)
Name and Address of School*
Class at Present*
State when doing Leaving Cert*
Are there other siblings in the family? If so please state their ages:

Preparation Course for Leaving Cert Irish Oral - Leaving Cert
X4: 21 November 2020-20 February 2021
| €50 deposit | €250 total
Amount you are paying now: €54 (includes a €4 online booking fee)
Parent / Guardian Name*
Parent / Guardian Telephone Number*
Home telephone number or number at which you can be contacted*
In an emergency state the name and telephone of person who may be contacted*

Preparation Course for Leaving Cert Irish Oral - Leaving Cert
X4: 21 November 2020-20 February 2021
| €50 deposit | €250 total
Amount you are paying now: €54 (includes a €4 online booking fee)
State How Travelling*
Station from which you will be travelling
Do you intend bringing a bicyle?
Please note: bicyles are not allowed on our Coláiste Íde (Residential Boarding College) but are on other courses. If you are bringing a bike it is compulsory to bring a helmet.
Have you attended a Colaisti Chorca Dhuibhne course before
When do you attend previous course?*
How did you hear of this course*
Other Source*
Friends

Maximum of 3 friends
Accommodation will be randomly allocated if no names are written in.
Changes may be considered up to one month prior to course commencement.
Friend 1
Enter 1 name only
Friend 2
Enter 1 name only
Friend 3
Enter 1 name only
Has your child any special needs regarding health / diet
Health Insurance / Medical Card Number
Do you accept images may be used for promotional purposes?

Preparation Course for Leaving Cert Irish Oral - Leaving Cert
X4: 21 November 2020-20 February 2021
| €50 deposit | €250 total
Amount you are paying now: €54 (includes a €4 online booking fee)
I Accept the Terms & Conditions and Cancellation Policy*
- Yes
Click here to read the Terms & Conditions

Click here to read our Cancellation Policy

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