Application form - English - St. Patrick's College - DCU

COLLEGES OF EDUCATION
APPLICATION FORM FOR ADMISSION OF UNIVERSITY GRADUATES FOR A COURSE
OF TRAINING FOR PRIMARY TEACHING 2013/14
_________________________________________________________________________
APPLICATION NUMBER ________________________
Note this application cannot be processed without a valid Application Number.
Please see http://www.spd.dcu.ie/site/prospective_students/HowtoapplyGradDipinEd13.shtml
College of choice in order of preference
Please mark 1, 2, 3 in order of preference
St Patrick’s College, Drumcondra
Marino Institute of Education
1. Customary Name:
(to be used on College Records)
2. Name as on Birth Certificate:
(if different from above)
Froebel College, Blackrock
______________________________________________
Surname
Forename(s)
______________________________________________
Surname
Forename(s)
3. Address for all correspondence:
______________________________________________________________________
______________________________________________________________________
____________________Tel. No. (H):_________________ (W): ___________________
Mobile: ________________________ Email: _________________________________
4a. Date of Birth:
Photograph
Day Month Year
Please attach a recent
Passport sized photo
4b. Place of Birth (i.e. County, if born in Ireland;
Country if born outside Ireland):
__________________________________
5. Leaving Certificate Results: (Please enclose certified copy of results, see checklist reminder no. 4)
Leaving Certificate
Leaving Certificate
YEAR EXAM NO. YEAR EXAM NO.
Indicate clearly grades obtained
Indicate clearly grades obtained
Irish
English
Mathematics
Higher/Hons.Papers Ordinary/Pass Papers Higher/Hons.Papers Ordinary/Pass Papers
If you do not have the required Leaving Certificate results for eligibility, please state equivalent results
(see enclosed guidelines): ________________________________________________________________________________

6. Primary Degree Awards: If presenting a Level 8 honours degree to meet academic qualifications for eligibility,
please enclose certified copy of academic transcript (see checklist reminder no. 4). Applicants must provide evidence of their
award’s position on the National Qualifications Framework, either on the academic transcript or on other documentation
provided. Applicants must meet all entry requirements at the time of application .
Title of Degree: ________________________________________________________
Level of Degree: (Please tick relevant box)
First Class Honours Second Class Honours Grade 1
Second Class Honours Grade 2
Pass/Third Class Honours
Year Awarded: _____________
University: __________________________________
Name of Awarding Body:
Main Subjects studied:
(in brief)
_________________________________________________
_________________________________________________
7. Postgraduate Degrees: If presenting a major award at Level 9 or a major award at Level 10 qualification to meet
academic qualifications for eligibility, please enclose certified copy of academic transcript (see checklist reminder no. 4).
Applicants must provide evidence of their award’s position on the National Qualification Framework, either on the academic
transcript or on other documentation provided. Applicants must meet all entry requirements at the time of application .
Qualification Year Awarded Institution Subjects Result
8. Diplomas: (Please enclose certified copy of results, see checklist reminder no. 4)
Qualification Year Awarded Institution Subjects Result
9. Have you previously applied for this course? No Yes _______ Year ______
10. Employment Record (please complete in brief and if necessary, attach additional information):
Teaching:
Name & Address of Employer/s From To Nature of Duties – in brief
Non Teaching:
Name & Address of Employer/s From To Nature of Duties – in brief

11. General Information (if necessary, attach additional information):
Why do you wish to apply for this course?
Have you any work or other experience which might prove advantageous in pursuing the course?
If so give brief details
What attributes or characteristics do you feel you have which make you particularly suitable for this
course?
Other information deemed relevant to the application
12. Leisure Interests:

Application fee (non-refundable) €45 must be paid online when you register your interest in
the course. Please see http://www.spd.dcu.ie/site/prospective_students/HowtoapplyGradDipinEd13.shtml
Please return this form and all supporting documents to:
Dublin Colleges of Education Central Office, c/o Admissions Office – D118
St. Patrick’s College, Drumcondra, Dublin 9
CLOSING DATE FOR RECEIPT OF APPLICATION: 5 P.M. MONDAY 3RD DECEMBER 2012
Please note that no application will be accepted after this date and time.
CERTIFICATE OF POSTING
Claims that any application form, or letter relating to it, has been lost or delayed in the post will not be
considered unless a certificate of posting from a Post Office is produced in support of such claims.
The certificate may take the form of either Registration, or a Certificate of Posting obtained at the
time of posting. An application by email or fax will not be accepted.
Any applicant who does not satisfy the conditions of eligibility (set out in paragraph 3 of the
Department Regulations) will be disqualified from consideration even where this comes to light after
the interview has taken place. Applicants who are successful at interview will not be offered places
on the course until such time as all documentary evidence supporting their eligibility is supplied by
them to the College.
I hereby certify that the information given above is accurate and I accept that the provision of any
false information by me will disqualify me from consideration for a place.
SIGNATURE OF APPLICANT:____________________________ Date _ _ / _ _ / _ _ _ _
CHECKLIST REMINDER:
Before forwarding this application to the Admissions Office, please ensure that you have completed all
relevant sections of the form and have included the following:
1. Photograph (attached)
2. A valid Application Number at the top of this form.
3. Application fee payment. Please enclose copy of receipt.
4. Documentation as required in 5, 6, 7, and 8 (only)
NOTE:
Certified Copy: Is a copy of the original transcript of results stamped and signed certifying that it is
a true copy by a Priest or other Minister of Religion, Teacher, Garda, Commissioner for Oaths or
registered Medical Practitioner.
or Minister of Religion
5. Please ensure you have signed and dated your application form
Please note that your application cannot be considered unless your application Fee Payment has been
made and the appropriate supporting documentation has been submitted.