Institute of Technology

Institute of Technology

TRALEE

InstitiúidTeicneolaíochtaTráLí

/ Bachelor of Arts in
Early Childhood Practice
Application Form
for intake
September 2016
(applicants must be holders of a FETAC Level 6 Childcare Qualification or equivalent)

PERSONAL DETAILS

SURNAME / STUDENT ID NUMBER (former students of MIC/UL/ITT only)
FIRST NAMES / DATE OF BIRTH / / / PPS Number
HOME ADDRESS / NATIONALITY
COUNTRY OF BIRTH
ADDRESS FOR
CORRESPONDENCE / HOME TEL. / MOBILE
EMAIL: / MALE  FEMALE 
Please include a passport size photograph with your application.
Have you been living in an EU country for 3 of the last 5 years? Yes  No 
Do you have a Disability/Specific Learning Difficulty? Yes  No 
(If you indicate ‘Yes’ we will be requesting further information, which will be treated confidentially)

EDUCATIONAL RECORD

Name of FurtherEducationCollege attended:
Address of College: / Contact Name:
Title of FETAC NCVA Level 6 Qualification*
Certificate in Childcare (DCXXX)  / Other, please specify:
Year: ______

* Please Attach Official FETAC Transcript of Results

Name of Higher Education College
(if applicable):
Address of HE College:
Title of Qualification(s):
______
______
______
______ / Year: ______
Year: ______
Year: ______
Year: ______

* Please Attach Official Transcript of Results

EMPLOYMENT DETAILS (continue on additional sheets if necessary, most recent first)

Name & Address of Employer / Job Title / From-To / Description of Duties

ADDITIONAL INFORMATION RELEVANT TO YOUR APPLICATION

DECLARATION (Must be Signed and Dated by applicant)

Please note that it is necessary to successfully complete Garda Vetting. Details will be sent to you on return of this completed application form.

I certify that the information I have provided on this form is accurate to the best of my knowledge. I agree that Mary Immaculate College/IT Tralee have authority to seek information from other Institutions in order to evaluate the information provided on this form. If admitted to Mary Immaculate College/IT Tralee I agree to abide by such Institutions’ Rights & Responsibilities as are in force from time to time.

Signature of Applicant:______Date:______

SUBMISSION OF APPLICATIONS

Applicants should return this completed application form to:

Admissions Office, Mary Immaculate College, South Circular Road, Limerick

061 204348/061 204929

Email:

Closing date for receipt of completed application forms is15th June, 2016

PROGRAMME FEES €1,850 PER SEMESTER

PLEASE NOTE: Candidates without a Level 6 Childcare qualification or equivalent must submit their application and supporting RPL documents by Friday 3rd June 2016to: Gerard O Carroll,North Campus, Institute of Technology Tralee, Dromtacker, Tralee Co. Kerry.

Office Use Only
Eligible: Yes  No 
Signed Head of School/Department ______Date ______/ Date Received Stamp