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Foirm Iarratais (Ollscoil na hÉireann, Má Nuad)

Ollscoil na hÉireann, Má Nuad - "Tar Linn ag Teagasc"

9 - 15 Meitheamh 2019


* Eolas riachtanach / Required information
*Ainm / Name:
*Sloinne / Surname:
*Inscne / Gender: Fear / Male
Bean / Female
*Seoladh 1 / Address 1:
*Seoladh 2 / Address 2:
*Contae / County:
Eirchód / Eircode:
*Dáta Breithe / Date of Birth:
*Fón / Phone:
*Ríomhphost / Email:
Scoil / School:
Ainm do mhúinteoir Gaeilge / Name of your Irish Teacher:
*Teagmhálaí i gcás éigeandála / Contact in an Emergency
Uimhir Ghutháin (Líne Thalún / Landline):
Uimhir Ghutháin (Fón Póca / Mobile):
Gaol / Relation (e.g. tuismitheoir (parent), deartháir (brother), cara (friend)):

1. Cén chaoi a gcuirfeá síos ar do chumas Gaeilge / How would you describe your knowledge of Irish?

Lag / Weak        
Réasúnta / Reasonable Go maith / Good 
An-mhaith / Very Good
Líofa / Fluent      
Tuiscint / Understanding
Léitheoireacht / Reading
Labhairt / Spoken
Scríobh / Writing

2. Céard iad na ceardlanna lae / na himeachtaí sóisialta oíche is mó a mbeadh spéis agat iontu / Which evening activities would you most enjoy?
(Liostaigh / List 1 – 5, 1 = an-spéis / very interested; 5 = gan mórán spéise / not much interest)

Damhsa ar an Sean-Nós/Céilí / Sean-Nós dancing / céilí:
Ceardaíocht / Crafts:
Tóraíocht Taisce / Treasure Trails:
Tráth na gCeisteanna Boird / Table Quiz:
Na hEalaíona / The Arts:
Aon mholadh eile / Any other recommendation?:
3. Ar chóir go mbeadh muid ar an eolas faoi aon cheann de na nithe seo a leanas / Should we know about any of the following health issues or physical impairments? (Riocht Sláinte (Health condition) - Tinneas (Illness), Ailéirge (Allergy), Eile (Other)
Tabhair sonraí, le do thoil / Please give details)
4. An bhfuil riachtanais speisialta bia agat / Do you have any special dietary requirements?
Na Rialacha / The Rules
  • Is cúrsa cónaithe é seo agus tá sé éigeantach do na rannpháirtithe fanacht i lóistín de chuid an Acadaimh le linn an chúrsa / It is mandatory that the students stay in accommodation provided by the Acadamh.
  • Is Gaeilge amháin is ceadmhach do na scoláirí a labhairt le linn an chúrsa / Irish is the only permitted language to be spoken by the students during the course.
  • Is cóir do scoláirí meas a léiriú ar mhuintir an tí, ar mhaoin an tí agus iad féin a iompar go béasach, múinte i gcónaí / The students must always respect the members of the household, the property and to conduct themselves in a mannerly fashion at all times.
  • Níl sé ceadaithe deochanna meisciúla a thabhairt isteach ná a ól in aon cheann de na tithe lóistín / Alcohol is not permitted in any of the accommodation.
  • Caithfidh gach scoláire cloí le hamchlár an chúrsa agus freastal ar na himeachtaí ar fad a bheidh eagraithe le linn an chúrsa / All the students must adhere to the course timetable and attend all organised activities during the course.

Cosaint Sonraí / Data Protection
Ní úsáidfear do chuid sonraí pearsanta ach amháin chun críche an chúrsa seo ar a bhfuil tú ag déanamh iarratais. Roinnfear na sonraí cuí leis na Páirtithe Leasmhara agus le do Bhean a Tí ach ní roinnfear do chuid sonraí le haon eagraíocht eile.
Your details will only be used for the purpose of this course. The appropriate details will be shared with the relevant parties and with Bean an Tí but your details will not be shared with any other organisation.