International Summer School: Education in Ireland 2013 Online Application Form

Welcome to the Online Application area for NUI Galway's Education in Ireland International Summer School Programme.

Closing Date for application to this programme is April 26, 2013.

There are two steps in this Application Process:
1. Fill in an Online Application Form, see below.
2. Post Relevant Supporting Documentation, see below.

1. Online Application:
Please note that you do not have the facility to "save" the application and return to work on it at a later stage, it must be completed in one sitting, it is recommended therefore, that you scroll down through the form initially and look at it carefully before you start to complete it. Thank you.

(Those marked with * must be answered)

1) Last Name*:

2) First Name(s)*:

3) Title*:
Mr   Mrs   Ms   Miss   Other (please specify)

If you selected "other", please specify:

4) Gender*:
Male   Female

5) Date of Birth*: (Format Day Month Year)
Format DD/MM/YYYY

6) Nationality:

7) Correspondence Address*:
Address Line 1
Address Line 2
Address Line 3
Address Line 4
State and Zip Code:

8) Telephone:

9) Email Address*:
(PLEASE ENSURE YOU PROVIDE A VALID EMAIL ADDRESS AS ANY FURTHER CORRESPONDENCE FROM NUI GALWAY PRIOR TO REGISTRATION WILL BE EMAILED TO THE EMAIL ADDRESS YOU PROVIDE)

10) Particular Student Needs:
Access (Wheelchair, etc)
Learning Supports (Dyslexia, etc)
Other (please specify)

If you selected "other", please specify:

11) Education Area/Topics of Special Interest:

12) Specifiy your accommodation preference*:
None required
Family Guesthouse - Sharing
Family Guesthouse - Single Occupancy
Student Residence - Single Occupancy

13) Additional Information:

2. Supporting Documentation Required:

1. Deposit of €375 (Tuition €250 / Accommodation €125) - can be processed as one
transaction.
International Bank Draft payable to National University of Ireland, Galway or by bank transfer:
Bank of Ireland, 43 Eyre Square, Galway
Account Number 28453773
Sort Code: 90 38 16
IBAN No: IE42 BOFI 90381628453773
BIC (Bank Identifier Code is the SWIFT address of the receiving bank) BOFIIE2D
Please notify Summer School Office when payment has been processed and if possible forward a copy of receipt/giro.
Transfer must be made in Euros and ensure "Summer School" and applicants name is referenced on all bank transfers; if a third party is processing payment, please ensure same.
2. Copy of Birth Certificate/Passport.

3. Passport Photo

The above Supporting Documentation is required to supplement your online application and should be forwarded to:

Fiona Dwyer
Administrator
Education in Ireland Summer School
Summer School Office
National University of Ireland, Galway
IRELAND
or e-mailed to fiona.dwyer@nuigalway.ie

Delaying sending in these documents means your application cannot be processed.

The Balance of tuition/fees and accommodation payments must be finalised by May 31, 2013

Check that you have answered all questions.
When completed, please press "submit" to send your application, you are then directed to a Thank You page, which will confirm your application has been successfully submitted.
Best of luck with your application.

Address Line 1
Address Line 2
Address Line 3
Address Line 4
State and Zip Code: