Foirm Iarratais / Programme Application Form

You can print out the form and post it together with the deposit to the address below. Please make cheques/bank drafts payable to Coláiste na Rosann.

Coláiste na Rosann,
Anagaire,
Leitir Ceanainn,
Co. Dhún na nGall.

For more information contact 00-353-(0)74 9548562 or Joe at 00-353-86 2600549

Foirm Iarratais 2012 / Application Form
Please choose dates From To
Ainm/Name  
Seoladh/Address

 

 
Fón/Telephone
Other Contact no.:
Dáta Breithe/Date of Birth:   Email:
Aois/Age:   Gnéas/Gender
Buachaill
Cailín


Have you been to Coláiste na Rosann before? Yes If Yes, please state years:
No
House Preference (If any)  
Name of Friend(s) you wish to stay with
Name and address of School

 

 
Múinteoir/Name of Teacher   Present year/class in School

Standard of Irish:

Weak Fair Good Excellent
Will you avail of coach transport? Yes No

Please note you will be advised of pick-up point prior to course commencement.
Name of family doctor

Address of family doctor

 
Telephone of family doctor
Medical / health insurance no. (if applicable)

I have read, understood and accept the rules and regulations as outlined by Coláiste na Rosann. Yes No

Deposit Amount         Cheque Cash Other