FINANCE OFFICE: Date Recd

FINANCE OFFICE: Date Recd.

OFFICE USE: E.N.

Allapplicantsmustattacharecentpassportphoto.

STAPLE

PHOTOHERE.

Withoutaphotoyourapplicationformwillbereturned.

EXAMINATIONAPPLICATION DETAILS FORM

AnScrúdúlehAghaidhCáilíochtasaGhaeilge SCG

SchoolAcademicYear2017–18.

This application form is for applicants who have opted to fulfill the Irish Language Requirement by Aptitude Test – An Scrúdú le hAghaidh Cáilíochta sa Ghaeilge. S.C.G. Pleaseprintlegiblyusingblockletters. Allsectionsoftheformmustbecompleted.Theapplicationformconsistsof6pages.Donotremoveanypage(s)fromtheform.Foryourapplicationtobeacceptedyoumustattachaphotoonpage1 and if applicable on page 2.Withoutaphoto(s),yourapplicationformwillbereturned. ReturnthecompletedformtoTHE FINANCE OFFICE. (SCG APPLICATION), MARINO INSTITUTE OF EDUCATION, GRIFFITH AVENUE, DUBLIN 9.by31st October.’17.

1 APPLICANT DETAILS: First ever application  or Had applied before 

Firstname(s)infull:

2EXAMINATIONDETAILS:

Iwishtoregisterfor: (Tickoneboxonly.)

ExamOnly.ExamCourseCourseOnly

Surname:

Address for Correspondence:

Telephonenumber(includecode):Mobile.

Work.Home

P.P.S.Number:

MODULES:PleaseticktheModulesoftheExamwhichyouwishtositinApril2017.

Paper1

Amountpaid online with application:€

Please seeFEE PAYMENT SCHEDULEfor payment options.

Payment must be made online at by following

theEASY PAYMENTS PLUS íoc ar líne button link.

You must write your EASY PAYMENTS PLUS receipt numberhere:

EXAM VENUE:

Teacher Number

Yourdateofbirth(example230375)

DayMonthYear

SignatureofApplicant:Date:

EXEMPTION STATUS:

HaveyoubeengrantedanExemptionfrompartsoftheS.C.G. If yes please attach copy of exemption letter.

YES: NO:

APPLYING NOW:

SignatureofWitness(Adult): Date:

S.C.G. EXAM APPLICATION DETAILS FORM: PAGE 1

OFFICE USE: E.N:

OFFICE USE: D.R:

IfyouareundertakingPaper1orPaper2orboththenyoumustattachaphotohere.

STAPLE

PHOTOHERE.

IfnotundertakingPaper1orPaper2thenaphotoisnotnecessaryhere.

PRACTICAL ELEMENT(S) APPLICATION FORM A(Paper1Paper2).

AnScrúdúlehAghaidhCáilíochtasaGhaeilge

SchoolAcademicYear2017–2018.

1 APPLICANTDETAILS:

Firstname(s)infull:

3 SCHOOL DETAILS:

SchoolName:

Surname:

SchoolAddress:

Address for correspondence:

SchoolTelephonenumber(includecode):

Telephonenumber(includecode):Mobile.

Home.

P.P.S.Number:

Teacher Number

Yourdateofbirth(example230375)DayMonthYear

2 VISITDETAILS:

Youwillreceiveonevisitduring the period below:

Period15 January – 09Feb 2018.

You will receive a letter from your supervisor at least three weeks prior to your visit, which will indicate the date and time of your school visit. It is your responsibility to make yourself available at the appointed day and time.

NOTE:

The school visit must take place during the above time period.School closures must be notified on page 3 of the form, or if subsequent to application to ()

SchoolRollNumber:

SchoolOpeningTime:
MorningBreakTime:
LunchBreakTime: / a.m.
from:to:
from:to:
Closing Time / p.m.

Class level you are or will be teaching. The Practical Element must be undertaken with a mainstream class.

NameofPrincipalTeacher(BlockLetters):

4 PERMISSION:

Theabovenamedapplicantisapplyingtoundertake theS.C.G.Examination which includesapracticalelementassessedintheclassroom.Yourpermissioninthisregardisrequestedbytheapplicant.(PleasenotethatthisisnotaletterofrecommendationfromThe Irish Language Requirement Office or Marino InstituteofEducation.Principalteachers/BoardsofManagementareaskedtosatisfythemselvesastothesuitabilityofanyindividualapplicantrequestingthispermission.Prospective candidates should be in the process of registering with the Teaching Council. Additional information available at

SignatureofPrincipalTeacher: Date:

SCG PRACTICAL ELEMENT(S) FORM A: PAGE 2

S.C.G.

PRACTICAL ELEMENT(S) APPLICATION FORMB (Paper1Paper2).

INFORMATION MAP.You mustdraw a clear map which will guide the supervisor directly to your school

If your school is in a rural area, direct your supervisor from nearest town. If in an urban area direct from nearest landmark.

DIRECTIONS.

You mustwrite clear directions which will guide the supervisor to your school:

SCHOOL CLOSURES.

If there are known school closures during the period 15 January – 09February2018youmust inform us of these. Please outline known school closures below. You must inform the Irish Language Requirement Office () of any additional closures during the above period as they become known to you. If you change school you must complete and forward a School Update Form (available at to the Irish Language Requirement Office.

PRACTICAL ELEMENT(S) FORM B: PAGE 3

Officeuse

Officeuse

INFORMATION FORM.

AnScrúdúlehAghaidhCáilíochtasaGhaeilge

SchoolAcademicYear2017–2018.

Thisinformationsectionshouldbecompletedclearlyandlegibly.Theinformationprovidedwillallowustoprovidemorefocusedadvice,guidanceand

informationtocandidateswhoundertaketheS.C.G.andwillaidusinfutureplanningforS.C.G.candidates.Pleasedonotwriteyournameonthispage.

Theinformationprovidedonthispageisprovidedforstatisticalpurposesonly.

1 STATISTICALINFORMATION:

Pleasecompletethefollowinggivingdetailsofyourteachingqualifications:

NameofCollegeAttended:

MODULESTOBEACHIEVED:Pleasetickthe

ModulesoftheExamwhichyouwilltakenext Easter. Intherighthandcolumnpleasewritethenumberoftimes

youhaveundertakenthemodule previously.

AddressofCollege:

MODULESALREADYACHIEVED:PleaseticktheModulesoftheExaminwhichyouhavealreadyachievedapass.Intherighthandcolumnpleaseindicatethenumberoftimesyouundertookthemodule

toachieveapass.

Yearsattended(e.g.1995-1998):

DateQualificationwasawarded:

Inyourcurrentschoolwhatteachingpositiondoyouoccupy:



Nationality:

IfIrish,yourCountyofbirth:

GAELTACHT:Inregardtothe3weekGaeltachtrequirement,pleaseindicatebytickingthenumberofweeksyouhavecompletedthusfarintheGaeltacht.



0Weeks
1Week
2Weeks
3Weeks

REGISTRATION WITH CONDITIONS:Inregardto

‘conditionalregistration’pleaseindicatethenumberofyearsof‘conditionalregistration’whichyouhave

remaining.

Countyinwhichyounowteach:

SCG INFORMATION FORM: PAGE 4

Officeuse E.N:

D.R:

S.C.G.COURSE REQUEST FORM.

AnScrúdúlehAghaidhCáilíochtasaGhaeilge

SchoolAcademicYear2017–2018.

S.C.G.CoursesmaybeprovidedbytheEducation/TeacherCentreslistedbelow.

Thecourseswillbeprovidedsubjecttosufficientdemand beingindicatedforcourses. Payment for courses is made directly to the Education Centre.Thefinaldecisionregardingtheviability/feasibilityofacourserestswitheachindividualcentre.

(1)Pleaseindicateifyourequireacourse.

Pleaseindicatewhetheryourequireabeginnercourse(Level1)oracourseinpreparationfortheExam(Level2).

(2)Pleaseindicateyourcentreofpreferencebyplacing1(firstchoice),2(secondchoice)and3(thirdchoice).

Uponreceiptofthisform the Irish Language Requirement Officewillforwardyourdetailsdirectly toyourcentreofchoicesothat

coursesmaybeprovidedandcoordinated.

Candidates should also contact the Education Centre directly to ascertain course availability and course information.

Ifaviablecoursedoesnotmaterialiseatyourfirstchoiceofcentre,thenyourdetailswillbeforwardedtoyoursecondchoicecentre.IfyouhavealreadycontactedanEducationCentre,itisstillnecessarytocompletethisform.

APPLICATIONDETAILS:

Firstname(s)infull:

Surname:

COURSEREQUIREMENT:Tickoneboxonly:

A.IrequireaBeginnerCourse:

B.IrequireaCoursetopreparefortheExam:

C.IdonotrequireaCourse:

Address for Correspondence:

CENTREPREFERENCEFORCOURSE:

Centresarelistedbelow,pleaseplace1(firstpreference)and2(secondpreference)and3intheboxesbesideyourpreferredvenue(s).Probablecourselocationis indicatedinbrackets.

Telephonenumber(includecode):

Mobile.Work.

Home

P.P.S.Number:

Teacher Number

SchoolNameandAddress:

County

Signature:

Date:

SCG COURSE REQUEST FORM: PAGE 5

SCG / EXEMPTION APPLICATION FORM
(A candidate who has Irish as a major subject in his/her degree qualification is entitled to exemption from part(s) of the S.C.G. Candidates are asked to consult the exemption policy outlined in the S.C.G. Guide available from , before completing this section. If you do not have Irish as a major subject in your degree qualification then you do not have to complete this page.
Declaration: (Please indicate) / I am applying for an Exemption  or I am not applying for an Exemption 
Name:
Address:
Email address :
PPS Number / OFFICE USE ONLY.
(Initial Office Check)
Name of Degree in which you had Irish as a major subject:
Name of College/University in which you undertook the degree in which you had Irish as a major subject:
Years of attendance: / 1 2 3 4

Duration of Degree in years: / Years / 1 2 3 4

Number of years in which you had Irish as a Major subject: / Years / 1 2 3 4

DOCUMENTATION: Items to accompany this application for an exemption:
A. A copy of the original and full transcript of your results for the degree in which you had Irish as a major subject. The transcript should be clear, legible and should indicate your results for each year of your degree.
Please tick as appropriate:
I have included a copy of my full transcript  I have not included transcript 
GAELTACHT:
B. If seeking exemption from week(s) in the Gaeltacht then you must submit written documentation (copy) from your college/university certifying that you have completed the week(s) as part of your degree.
Please note that you must have attended the Gaeltacht course in the capacity of a learner. Please indicate the number of Gaeltacht weeks for which you are seeking exemption:
0 Weeks  1 Weeks  2 Weeks  3 Weeks  / 1 2 3 4

You may provide any additional notes here:
Please attach/staple a copy of the transcript and any other supporting documentation to this Exemption form.
This form should then be submitted with your SCG application. Please ensure that you have indicated at the bottom of page 1 of the S.C.G. application form that you are applying for an Exemption.
(Note: If you are awaiting transcript and/or supporting documentation then you should forward pages 1-5 of your application form now and retain and submit page 6 with the required documentation as soon as possible.)
OFFICE USE ONLY
Examination: / Gaeltacht: / Notes:

SCG EXEMPTION APPLICATION FORM: PAGE 6

Please return completed form to:

