Application Form for Admission 2023/2024 Step 1 of 7 14% Níl san fhoirm seo ach foirm iarratais ar ligean isteach agus ní hionann í agus tairiscint áite, bíodh tairiscint intuigthe i gceist nó tairiscint eile. Ní chiallaíonn úsáid an fhocail 'scoláire' ar fud na Foirme Iarratais seo go meastar gur glacadh leis an duine a bhfuil an t-iarratas seo á dhéanamh ina leith mar scoláire de chuid This is an application form for admission and does not constitute an offer of a place, implied or otherwise. Use of the word ‘student’ throughout this Application Form does not imply that the person on whose behalf this application is being made is regarded as a having been accepted as a student of Coláiste Pobail Osraí For more information on key dates and policies click here > Féach chuige le do thoil go gcuirfidh tú na cáipéisí seo a leanas ar ais chuig an scoil chun an t-iarratas a thabhairt chun críche Please ensure you return the following documents to the school to complete the application: An bunleagan den teastas breithe fada (agus cóip de freisin) An original long birth-certificate (together with a copy) Coláiste Pobail Osraí, Br Urmhumhan, Cill Chainnigh Glacfar le foirmeacha iarratais ón/Completed applications will be accepted from: 13/10/22 Is é an dáta deiridh ar an nglacfar le hiarratais/The closing date for receipt of applications is: 24/10/2022 Cuir tic leis an mbliain ghrúpa a bhfuil an scoláire ag cur isteach air/Please tick the Year Group the student is applying to enter: An Chéad Bhliain/First Year An Dara Bliain/Second Year An Tríú Bliain/Third Year An Idirbhliain/Transition Year An Cúigiú Bliain/Fifth Year An Séú Bliain/Sixth Year Roinn / Section 1Sonraí an té a Bhfuil Iarratas á Dhéanamh ina Leith /Prospective Student DetailsSonraí an duine óig a bhfuil an t-iarratas seo á dhéanamh ina leith. Details of the young person for whom this application is being made. Céadainm/First Name Dara hAinm/Middle Name Sloinne/Surname Seoladh an Scoláire/Student Address Address Line 1 Address Line 2 Town/City County Éirchód/Eircode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country UPSP/PPSN Dáta Breithe/Date of Birth DD slash MM slash YYYY Primary Contact InformationThese are the primary contact details for the applying student. If the applicant is under 18 years of age these should be the contact details of their parent or guardian.Uimhir theileafóin / Telephone no.Seoladh ríomhphoist / Email address Roinn / Section 2Sonraí Faoi Thuismitheoir/Caomhnóir/Details of Parent/GuardianNÍ GÁ an roinn seo a chomhlánú sa chás ina bhfuil 18 mbliana slánaithe ag an scoláire, mura rud é gur mhaith leis nó léi go ndéanfadh an scoil cumarsáid le tuismitheoir/caomhnóir an scoláire faoin iarratas seo, in ionad teagmháil dhíreach a dhéanamh leis an scoláire féin. Iarrtar an fhaisnéis seo chun teagmháil a dhéanamh faoin iarratas seo. Má luaitear níos mó ná ainm amháin ach gurb é an seoladh céanna a bheidh ag gabháil leis an dá ainm, ní eiseofar ach aon litir amháin agus cuirfear an litir sin chuig an mbeirt. This section is NOT required to be completed where the student is over 18, unless s/he wishes the school to communicate with his/her parent/guardian about this application instead of directly with the student. The information is sought for the purposes of making contact about this application. If more than one name is given but the address is the same, only one letter will issue and will be addressed to both individuals.Tuismitheoir/Caomhnóir Parent/ Guardian 1 An tUas/Mr.Bn/Mrs.Uas/Ms.Dr. Teideal/Prefix Céadainm/First Name Sloinne/Surname Address Parent Guardian 1 / Seoladh Tuismitheoir 1 Same As Student Address / Mar a cheile le seoladh an scoláire Different From Student Address / Difriúil le seoladh an scoláire Scoláire/Address Address Line 1 Address Line 2 Town/City County Éirchód/Eircode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Uimhir theileafóin / Telephone no.Seoladh ríomhphoist / Email address Gaol leis an scoláire / Relationship to student Mother Father Tuismitheoir/Caomhnóir Parent/ Guardian 2 An tUas/Mr.Bn/Mrs.Uas/Ms.Dr. Teideal/Prefix Céadainm/First Name Sloinne/Surname Address Parent Guardian 2 / Seoladh Tuismitheoir 2 Same As Student Address / Mar a cheile le seoladh an scoláire Different From Student Address / Difriúil le seoladh an scoláire Scoláire/Address Address Line 1 Address Line 2 Town/City County Éirchód/Eircode AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Uimhir theileafóin / Telephone no.Seoladh ríomhphoist / Email address Gaol leis an scoláire / Relationship to student Mother Father Roinn / Section 3Cód Iompair na Scoláirí/Student Code of BehaviourDearbhaigh, le do thoil, go nglacann tusa, i do cháil mar thuismitheoir/caomhnóir, le Cód Iompair na Scoláirí agus go ndéanfaidh tú gach iarracht réasúnta lena chinntiú go gcloífidh an Scoláire leis más rud é go bhfaighidh sé nó sí áit sa scoil. Tabhair do d'aire go bhfuil an Cód Iompair le fáil ar Cód Iompar an Choláiste nó ó oifig na scoile. Please confirm that the Student Code of Behaviour is acceptable to you as a parent/guardian and that you shall make all reasonable efforts to ensure compliance of same by the student if s/he secures a place in the school. Please note that the Code of Behaviour can be found at Code of Behaviour or from the school office. * Dearbhaímse, go nglacaim le Cód Iompair na scoile agus go ndéanfaidh mé gach iarracht réasúnta, i mo cháil mar thuismitheoir/caomhnóir, lena chinntiú go gcloífidh an scoláire leis más rud é go bhfaighidh sé nó sí áit sa scoil. I confirm that the Code of Behaviour for the school is acceptable to me as the student’s parent/guardian and I shall make all reasonable efforts to ensure compliance by the student if s/he secures a place in the school. Roinn / Section 4Rialacha Maidir Leis an Aois Íosta Chun dul Chuig an Meánscoil/Rules on Minimum age for Entry Into Secondary SchoolFaoi alt X den cháipéis 'Rialacha agus Clár na Meánscoileanna 2004/05' de chuid na Roinne Oideachais agus Scileanna ciallaíonn dalta aitheanta "dalta atá 12 bhliain d’aois ar a laghad an 1ú lá de Eanáir den scoilbhliain." Chomh maith leis sin, faoi roinn V, éilítear ar Phríomhoide "sliocht deimhnithe as clár poiblí breitheanna" a fháil. Dá bhrí sin, ní mór don scoil féachaint ar theastas breithe fada an linbh chun a mheas an gcomhlíonann sé nó sí an ceanglas sin. Under section X of the Department of Education and Skills’ Rules and Programme for Secondary Schools 2004/05, “A recognised pupil means a pupil who is not less than 12 years of age on the 1st day of January of the school year.” Also, section V requires a Principal to obtain a “certified extract from” the “public register of births.” Therefore, the school requires sight of the child’s long-form birth certificate in order to assess whether s/he meets the requirement.Cuir tic sa bhosca le do thoil lena dheimhniú go bhfuil teastas breithe bunaidh fada an linbh agus fótachóip de iniata leis an bhFoirm Iarratais seo agat/Please tick the box to confirm that you enclose the child’s original long-form birth certificate and a photocopy of same with this Application Form Cuirim faoi iamh leis an bhFoirm Iarratais seo teastas breithe bunaidh fada an linbh agus fótachóip de. (Seolfar an bhunchóip ar ais chugat.) / I enclose the child’s original long-form birth certificate and a copy of same with this Application Form. (The original will be returned to you.) Roinn / Section 5Critéir Roghnúcháin Maidir le Ligean Isteach i gCás Liosta Feithimh a Bheith ann /Selection Criteria for Admission in the Event of OversubscriptionCuideoidh an fhaisnéis seo lena chinneadh an gcomhlíonann an scoláire na riachtanais ligin isteach de réir an oird tosaíochta a leagtar amach sa roinn is infheidhme de Chuid B den Bheartas Ligin Isteach i leith Coláiste Pobail Osraí. This information will assist in determining whether the student meets the admission requirements in accordance with the order of priority as set out in the applicable section of Part B of the Admission Policy for Coláiste Pobail Osraí A. Má tá aon deartháireacha nó deirfiúracha leis an scoláire sa scoil faoi láthair, ainmnigh iad agus luaigh cén bhliain ina bhfuil siad. If the student currently has any siblings in this school, please indicate their names and current year of study. Number of siblings currently attending.NoneOneTwoThreeFour(i) Name Year (ii) Name Year (iii) Name Year (iii) Name Year B. Má bhí aon deartháireacha nó deirfiúracha leis an scoláire sa scoil san am atá caite, ainmnigh iad agus luaigh cén tréimhse inar fhreastail siad ar an scoil. If the student has previously had any siblings in this school, please indicate their names and years of attendance. Number of siblings previously attended.NoneOneTwo(i) Name Year: From - To / Bliain: Ó – Go (ii) Name Year: From - To / Bliain: Ó – Go C. Tabhair sonraí faoin mbunscoil ar ar fhreastail an scoláire. Please provide details of the primary school attended by the student. Ainm na scoile/School name Seoladh na scoile/School addressD. Iarrtar ort an fhaisnéis thíos a sholáthar chun tabhairt le fios cén leibhéal líofachta atá ag an scoláire sa Ghaeilge mar ghnáth-theanga chumarsáide. Please provide information below as an indication of the student’s level of fluency as a normal means of communication. Please indicate all that apply: An labhraítear Gaeilge go rialta sa bhaile/Is Irish regularly spoken at home Yes No An bhfuil cónaí ar an scoláire i gceantar Gaeltachta/Is s/he resident in a Gaeltacht area Yes No Aon chúinse eile a mheasann tú atá ábhartha i dtaobh líofacht a léiriú/Any other factor that you feel may be relevant to demonstrate fluencyFaisnéis Thábhachtach Is gá duit na cáipéisí seo a leanas a sheoladh isteach: i) An bunleagan den teastas breithe fada (agus cóip de freisin) Glacfar de mheon macánta leis an bhfaisnéis go léir a chuirfidh tú ar fáil san fhoirm iarratais seo. Má fhaightear amach go bhfuil aon chuid den fhaisnéis mícheart, míthreorach nó easnamhach, d'fhéadfadh an t-iarratas a bheith neamhbhailí. Iarrtar ort a thuiscint gur tusa féin atá freagrach as an scoil a chur ar an eolas faoi aon athruithe ar shonraí teagmhála nó ar na cúinsí a bhaineann leis an iarratas seo. Le haghaidh faisnéis maidir leis an gcaoi a ndéanann an scoil agus BOOCCC do chuid sonraí a phróiseáil, féach thall le do thoil. Sínigh thíos le do thoil, lena chur in iúl go bhfuil an fhaisnéis sin léite agat agus go dtuigeann tú í. TABHAIR DO D'AIRE: Má fhaigheann an scoláire áit Coláiste Pobail Osraí, ní hé sin le rá go sannfar a rogha ábhair dó/di, mar gheall ar dheacrachtaí ó thaobh acmhainne agus/nó srianta ar líon na scoláirí in aghaidh an ranga.Important Information You are required to submit: (i) An original long birth-certificate (together with a copy). All of the information that you provide in this application form is taken in good faith. If it is found that any of the information is incorrect, misleading or incomplete, the application may be rendered invalid. Please understand that it your responsibility to inform the school of any change in contact information or circumstances relating to this application. For information regarding how your data is processed by the school and KCETB, please see overleaf. Please sign below to demonstrate that you have read and understood this information. NOTE: Should the student receive a place in Coláiste Pobail Osraí there is no guarantee that the student will be assigned his/her selected subject choice due to resource issues and/or restrictions on the numbers of students per class. (Tuismitheoir/Caomhnóir 1) (Parent / Guardian 1) I have read and understood the above information.Dáta/Date DD slash MM slash YYYY (Tuismitheoir/Caomhnóir 2) (Parent / Guardian 2) I have read and understood the above information.Dáta/Date DD slash MM slash YYYY (An Scoláire [i gcás ina bhfuil 18 mbliana slánaithe acu])(Student [where over 18]) I have read and understood the above information.Dáta/Date DD slash MM slash YYYY View Our Data Protection Policy Here: Cosaint Sonraí / Data Protection Δ
