Application Form (PDF) - St. Patrick's College - DCU

ST PATRICK’S COLLEGE, COLÁISTE PHÁDRAIG,
DRUMCONDRA, DUBLIN 9 DROIM CONRACH, B.Á.C. 9
(A College of Dublin City University) (Coláiste de Chuid Ollscoil Bhaile Átha Cliath)
DOCTORATE IN EDUCATION (EdD)
APPLICATION FORM
This form is to be completed in TYPESCRIPT or in BLOCKLETTERS using BLACK ink. All
questions must be answered. Where appropriate write ‘none’ or ‘not applicable’. DO NOT leave blanks.
The completed application form, together with the necessary supporting documentation and application
fee of €30, should be returned to:
Admissions Office, St Patrick's College, Drumcondra, Dublin 9, Ireland
Telephone: +353-1-8842025/ 8842096 Fax: +353-1-8376197
Email: courseinfo@spd.dcu.ie Web: www.spd.dcu.ie/pg
1. CUSTOMARY NAME: _____________________________________________________
(to be used on all official College records) Surname Forename(s)
2. NAME AS ON BIRTH CERTIFICATE: ____________________________________________________
(if different from above) Surname Forename(s)
3. ADDRESS FOR CORRESPONDENCE: 4. HOME ADDRESS: (if different from No. 3)
_________________________________
_________________________________
_________________________________
_______________________________________
_______________________________________
_______________________________________
5. HOME TELEPHONE: ____________________ WORK TELEPHONE: ______________________
MOBILE TELEPHONE: __________________ EMAIL ADDRESS : ______________________
6. PLACE OF BIRTH: ________________ COUNTRY OF BIRTH:__________________
7. NATIONALITY: ________________
8. DATE OF BIRTH: _____/____/ ____ 9. GENDER: MALE FEMALE
DD MM YY (Please tick)
10. TEACHER COUNCIL NO. (if applicable) ____________________
11. TEACHER PAYROLL NO. (if applicable) _____________________
12. PPS NUMBER ______________________

13. DETAILS OF THIRD LEVEL EDUCATION AND QUALIFICATIONS:
Primary Degree Title: ______________________________________________________
Level/class of Award H1 H2.1 H2.2 H3 Pass Other (Please detail below)
___________________________________________________
Institution Attended:
___________________________________________________
Period of Attendance: ______________________ Date of Award: _________
Name of Programme:
____________________________________________________
Length of Programme: ______________________ Full-time Part-time
Name of Awarding Body: _____________________________________________________
Main Subjects Studied: ______________________________________________________
_______________________________________________________
14. OTHER THIRD-LEVEL EDUCATIONAL QUALIFICATIONS:
TITLE OF AWARD
AWARD 1 AWARD 2
Level/Class of Award
Name of Awarding Body
College Attended
Period of Attendance
Date of Award
Main Subjects Studied
15. OTHER ACADEMIC AND/OR PROFESSIONAL QUALIFICATIONS OR DISTINCTIONS:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
16. PLEASE INDICATE EMPLOYMENT RECORD: (begin with present employment)
Employment Position Held Responsibilities
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17. PARTICULAR ABILITIES: (Please indicate your proficiency level in the English language (and Irish language
where appropriate) together with knowledge of other languages including proficiency in computer skills, and any other
special aptitudes to support your applications. Non-native speakers of the English language should furnish
certification of proficiency in English such as TOEFL test results.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________________________________________________
18. Research Knowledge and Skills: (Please describe and self assess your level of expertise in each of the
following areas-if any. Note that this information will be used to plan for research methods courses. It will not be a
determining factor in any decisions made about course entry.)
Quantitative research for example survey methods and data analysis;
Qualitative methods for example ethnographies and analysis of interview and observation data;
Narrative methods and emancipatory and feminist approaches to research;
Philosophical or other non-empirical approaches.
19. DETAILS OF PUBLICATIONS (Indicate type of publication, i.e. book, paper, review etc. Please include authors
title, date and publisher. If there is insufficient space below, please attach details on an additional sheet.)
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
________________________________________________________________________________
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20. PLEASE SUBMIT A COPY OF A CHAPTER OF YOUR MASTER’S THESIS
Title of Thesis__________________________________________________
Title of Chapter_________________________________________________
Year Completed________________
21. OTHER RELEVANT EXPERIENCE/INFORMATION: (Indicate any other awards obtained, experience or
other details not already cited, which may be of use in assessing your application.)
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
22. CAREER OBJECTIVES: (State briefly but explicitly the basis of your interest in postgraduate studies and how
this relates to your career objectives.)
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
23. PLEASE INDICATE THE SUBSTANTIVE AREA (one only) OF INTEREST IN WHICH YOU WISH TO
PURSUE RESEARCH AND POLICY ANALYSIS
Choose one of the following:
(a) Ethical, Education and Schooling
(b) Learning, Teaching, Assessment and Curriculum
(c) Research and Evaluation
(d) Special and Inclusive Education
(e) Teacher Education
Preference:_________________________________________
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24. REFERENCES: It is your responsibility to ensure that you have included signed and sealed references from
three referees, two of which must be an academic referee.
1. Name of Referee _____________________________________________________
Address
______________________________________________________________________________
______________________________________________________________________________
________________________________________________
Tel No. ______________ Fax No. _________________E-mail: ________________
2. Name of Referee _____________________________________________________
Address
______________________________________________________________________________
______________________________________________________________________________
________________________________________________
Tel No. ______________ Fax No. _________________E-mail :________________
3. Name of Referee _____________________________________________________
Address
______________________________________________________________________________
______________________________________________________________________________
________________________________________________
Tel No. ____________
Fax No. _________________E-mail:_________________
25. Where did you hear about this programme?
___________________________________________________
26. DECLARATION
I certify that the information given in this application is correct. I will comply with St. Patrick’s College’s ethical
protocols and act ethically while conducting research and pursuing my studies as a registered student of the
College.
Recent Photograph
SIGNATURE OF APPLICANT: _________________________________
DATE: _________________________
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PLEASE NOTE:
(i)
(ii)
Certified copies* of official transcripts of results for all qualifications listed, including, for nonnative
speakers, certified proficiency in the English language, must be included with this
application. Originals should not be forwarded as all documentation is retained by the College.
Application forms which are incomplete or lacking the relevant documentation will be returned to
the candidate.
*Certified Copy: A photocopy of the original transcript of results signed, stamped and certified as a
true copy by a Priest, Teacher, Garda, Commissioner for Oats or registered Medical Practitioner,
or Minister of Religion.
If final examinations have not been completed, please indicate, in Sections 13-15 above, the date
when results are expected to be available. It is the applicant’s responsibility to ensure that all such
official degree results are communicated to the Admissions Office as soon as possible after
publication.
(iii)
(iv)
All official communications in respect of this application must be conducted through the Admissions
Office, St Patrick’s College, Drumcondra, Dublin 9, Ireland. References from your three referees
should also be sent to this office.
STUDENTS MAY PURSUE ONLY ONE COURSE OF STUDY IN St. PATRICK’S COLLEGE AT ANY
GIVEN TIME.
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DOCTORATE IN EDUCATION (EdD)
APPLICATION CHECKLIST:
All applications to Doctorate in Education (EdD) must be submitted on the College’s
official Doctorate in Education Application Form. Applications must also include the
following:
1. Certified copies of official transcripts of results. Copies of conferral
parchment will not be accepted.
2. A non-refundable application fee of €30.
3. A recent photograph, attached to page 5.
4. Signed and sealed references from three referees, two of which must be
an academic reference
5. If application is from a non-English speaking applicant, please submit
details of the standard of spoken and written English.
6. Official transcripts should be translated into English by a professional
translator. Applicants must provide evidence of their award's position on
the National Framework of Qualifications (www.nqai.ie), either on the
academic transcript or on other documentation provided.
7. Chapter from Master’s Thesis
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