1) Have you previously studied at NUI Galway?Yes No If you selected "yes" please specify what year you were registered:2) Surname*:3) First Name(s)*:4) Name by which you prefer to be known5) Name under which primary degree was conferred ( if different from above)6) Date of Birth*:Format DD/MM/YYYY7) Nationality*:8) PPS Number*:9) Gender*:Male Female 10) Private Address (for correspondence)Address 1Address 2Address 3Address 4County:11) Country of Birth*:12) Contact e-mail*: 13) Contact Telephone14) Telephone (Mobile)*:FORMAT 086600101215) Please provide particular student needs:Access (wheelchair access, etc. ) Learning Supports (Dyslexia etc.) Other (please specify) If you selected "other" please specify:16) Primary Degree Qualification:You will need to include an official transcript stating your subjects and grades of your degree programme along with your original degree certificate.Course 1 Year Attained:Name and Address of Awarding Institution:Full title of Degree attainedLevel/Grade of Degree attained:Course 2 Year Attained:Name and Address of Awarding Institution:Full title of Degree attainedLevel / Grade of Degree attained:17) Current Employer:Current Employer:Address:Your position:Start Date:Your responsibilities:Employer's Main Activities:Indigenous or Foreign owned Company:18) Previous Employment Experience:Employer 1:Address:Your position:Dates:Your responsibilities:Employer's Main Activities:Employer 2:Address:Your position:Dates:Your responsibilities:Employer's Main Activities:19) Module Selection:Modules can only be taken in sessions indicatedPlease tick one of the sessions below:Sept-Oct 2013Nov-Dec 2013Mar-Apr 2014May-Jun 2014MCT610 Software EngineeringMCT610 Software Engineering Sept-Oct 2013MCT610 Software Engineering Nov-Dec 2013MCT610 Software Engineering Mar-Apr 2014MCT610 Software Engineering May-Jun 201420) Module SelectionPlease tick one of the sessions below:Sept-Oct 2013Jan-Feb 2014Mar-Apr 2014MCT609 Fundamentals of ProgrammingMCT609 Fundamentals of Programming Sept-Oct 2013MCT609 Fundamentals of Programming Jan-Feb 2014MCT609 Fundamentals of Programming Mar-Apr 201421) ModulePlease tick one of the sessions below:Nov-Dec 2013Mar-Apr 2014May-Jun 2014MCT618 Object Oriented DesignMCT618 Object Oriented Design Nov-Dec 2013MCT618 Object Oriented Design Mar-Apr 2014MCT618 Object Oriented Design May-Jun 201422) ModulePlease tick one of the sessions below:Sept-Oct 2013Jen-Feb 2014Mar-Apr 2014MCT619 Object Oriented ProgrammingMCT619 Object Oriented Programming Sept-Oct 2013MCT619 Object Oriented Programming Jen-Feb 2014MCT619 Object Oriented Programming Mar-Apr 201423) ModulePlease tick one of the sessions below:Nov-Dec 2013May-Jun 2014MCT620 Distributed SystemsMCT620 Distributed Systems Nov-Dec 2013MCT620 Distributed Systems May-Jun 201424) ModulePlease tick one of the sessions below:Nov-Dec 2013Mar-Apr 2014MCT621 Artificial IntelligenceMCT621 Artificial Intelligence Nov-Dec 2013MCT621 Artificial Intelligence Mar-Apr 201425) ModulePlease tick one of the sessions below:Sept-Oct 2013Jan-Feb 2014May-Jun 2014MCT622 Real Time SystemsMCT622 Real Time Systems Sept-Oct 2013MCT622 Real Time Systems Jan-Feb 2014MCT622 Real Time Systems May-Jun 201426) ModulePlease tick one of the sessions below:Jan-Feb 2014MCT623 Graphics ProgrammingMCT623 Graphics Programming Jan-Feb 2014
Aisling MonahanCPD Programme CoordinatorAdult & Continuing Education OfficeNational University of Ireland, GalwayDelaying sending in these documents means your application cannot be processed.Please check that you have answered all questions. When completed, please press "submit" to send your application, you will then be sent an acknowledgment, so you will know it was successfully submitted. Best of luck with your application.