Foirm Iarratais
Coláiste Chiaráin,
Oileán Cléire, Co. Chorcaí

Cúrsaí Samhraidh 2008

Cuir sa bhosca (Tick the boxes):

5 - 27 Meitheamh (June) 2008 = €800
30 Meitheamh (June) - 22 Iúil (July) 2008 = €800
23 Iúil (July) - 14 Lúnasa (August) 2008 = €800

Buachaill
Cailín

Ainm:
(Name)

Seoladh:
(Address)

Dáta Breithe:
(Date of Birth)

Scoil:
(School)

Rang:
(Class)

Tuismitheoirí
(Parents)
Caomhnóirí:
(Guardians)

Fón do Thí nó uimhir chun teangmháil leat:
(Home Telephone or number at which you can be contacted)

An bhfuil aon fhadbh sláinte agat?
(Any health problems we should know about?)

 

Print and complete this form. Return together with €150 deposit.
The balance of fees must be paid before the commencement of the course.

Gaelachas Teo
Gleann Maghair
Co. Chorcaí

Teil: 021-482 1116
Faics: 021-482 1006
Ephost: gaelteo@eircom.net

Idirlíon: gaelachas.com