About Rathmines College
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  Application Form  
 
     
  * Indicates Required Fields. Please check all information before submitting application.  
  Personal Details  
  Surname:   *  
  Firstname: *  
  Home Address:  
  Dublin Address:  
  Email Address: * Nationality:  
  Emergency Contact Name:    Contact No:  
  Home No: * Mobile No:  
  Date of Birth * Sex:  
  P.P.S. Number *  Applications cannot be processed without this number.  
  Are you eligible to avail of full-time education in Ireland.   Yes    No  
     
 
     
 
  Course Choice  
  Course title for which you are applying:  
  First Choice  
  Second Choice  
  Third Choice  
     
 
     
 
  Status  
  Please tick the appropriate box to indicate your status on the year of application:  
  Attending School   Training: FÁS/CERT   Working    Third Level   Left School   Further Education  
       
 
     
 
  Second Level Education  
Number of years at Second Level
Name of School attended for Leaving Certificate
Address of School
School 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    Mode:   Traditional  LCVP   LCA   Other
List below, under the headings provided, the Leaving Certificate subjects and the results obtained (if available).
  Subject  Level  Result  
  Irish  
  English  
  Maths  
  Art  
  History  
  Geography  
     Subject  Level  Result  
  Science Subjects  
     
     
  Business Subjects  
     
     
  European Languages  
     
  Other  
     
Any Post Leaving Certificate Course or Third Level Course previously attended or completed:
Other Examinations
Work Exerience/Training
Other Information: The College has a social equality admisssions policy and will try to provide appropriate supports and services for all students accessing our courses. Do you have a health/disability or specific learning difficulty? Yes    No
If yes, state your condition:  
If you require and supports, please specify:  
This information will be treated as confidential and will not adversely affect your application
Important: Please indicate where you heard about our courses:
 
     
   Certified Copies of all qualifications and transcripts of results should be sent to college.  
   Outstanding results should be forwarded on receipt.  
     
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  Rathmines College, Town Hall, Rathmines, Dublin 6.  Tel: 01 497 5334  Email: info@rc.cdvec.ie
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