Marino College

Email Address:

Home No:

Mob No:

* P.P.S. Number:

* Applications cannot be processed without this number.

Country of Birth:

Nationality:

Date of Birth:

Gender:

Male

Female

Please complete a separate application form for each course you are applying for

Course choice:

Status

Please select the appropriate box to indicate your status on the year of application:

Attending School

Training: FÁS/CERT

Working

Third Level

Left School

Further Education

Unemployed

Other

Second Level Education (if attended)

Number of years at Second Level Schools

Name of School attended for Leaving Certificate

Address:

School Roll Number:

This Number is on the Top Left Hand Corner of your Leaving Certificate Result Transcript or obtainable from your current School.

Year Leaving Certificate obtained:

Type of Leaving Certificate:

List below, under the heading provided, the Leaving Certificate subjects studied and the most results obtained.

Secondary School Exam results

Leaving Cert Results

Mock Leaving Results

Christmas Exams

Fifth Year Summer Exams

Subjects Studied

H / O

Grade

Year results obtained

Other Courses

Other Education/Training Courses attended:

Qualifications/Certificates obtained:

Work Experience/Training which may be relevant to your application:

Other Information

The College has a social equality admissions policy and will try to provide appropriate supports and services for all student accessing our courses.

Do you have any health or specific learning dificulty?

Yes

If yes, please give further details:

If you require any supports, please specify:

English is the language of instruction on all programmes and courses at Marino College. Applicants whose first language is not English may be asked to undertake a language proficiency test on the day of their interview.
This information will be treated as confidential and will not adversely affect your application.

* Important: * Please indicate where you heard about our courses

Location on Sept 30th 2017 I was:

Attending School/College

Employed

Not in Labour Market

Other Training Programme

Unemployed 0-6 months

Unemployed 6-12 months

Unemployed 12 months and over

Please tick box to give permission for your photo to be used by the college for marketing purposes on our website, or other college information literature and posters

FOR STUDENTS OVER 18:

I consent to the information contained in this application form being notified to the Dept. of Education and Skills as part of the annual pupil enrolment returns.

FOR STUDENTS UNDER 18:

I consent to my son's/daughter's information contained in this application form being notified to the Dept. of Education and Skills as part of the annual pupil enrolment returns.