Foirm Iarratais
Nua-Coláiste Samhraidh, Gleann Maghair
, Co. Chorcaí

Cúrsaí Samhraidh 2008

19 Meitheamh (June) - 4 Iúil (July) 2008 = €680
7 - 22 Iúil (July) 2008 = €680
23 Iúil (July) - 7 Lúnasa (August) 2008 = €680

Buachaill
Cailín

Taisteal (Travel) by Car
Taisteal (Travel) by Public Transport

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.
Seol ar ais go dtí:

Gaelachas Teo
Gleann Maghair
Co. Chorcaí

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