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2021 Bookings

APPLICATION FORM

1 Enter Your Details
2 School Information
3 Course Details
4 Emergency Contact Details
5 Acceptance & Payment
  • Student Details

    Please enter the personal details of the student below, fields marked with an * are required.
  • (Students must be between 10-18 years of age at the start of the course date)
  • (This will be the main contact number for calls and SMS messages)
  • (This will be the email address used for correspondence )
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  • School Details

    Please enter details of your school and any college attended previously
  • Please enter student’s present class/ year group in school
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  • Course Details

  • Cúrsa A: 06/06/21 – 19/06/21 - 1st & 2nd years only - €780
    Cúrsa B: 20/06/21 – 03/07/21 - 1st & 2nd years only - €780
    Cúrsa C: 04/07/21 – 17/07/21 - All students - €780
    Cúrsa D: 18/07/21 – 31/07/21 - All students- €780
  • Your preferred course may be unavailable, so please select your next alternative course.
  • Are you a past pupil of Coláiste Chonnacht?
  • Guesthouse of your choice if there is room. To be completed only by past pupils. Preferred Guesthouse cannot be guaranteed.
  • Name of one friend you wish to be accommodated with.
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  • Emergency Contact Details

    Please enter details of your emergency contact and any medical issues we need to be aware of:
  • If parents are away during course state the name and telephone number of person who would be responsible for child / children in case of emergency.
  • Provide information on any health problems the applicant might have including existing medical illness and / or allergies. (Note: All medical fees are the responsibility of parents or guardian)
  • Please note that all medical expenses are the responsibility of the parent/ guardian. Parents are advised that it is in their interest to have Personal Accident Insurance. (If you have a current medical card send copy of same with application.)
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  • Acceptance & Payment

    A €250 Deposit Payment is payable on application. An online payment can be made below (subject to a €4.50 booking fee) or details of alternative payment options will be included in the booking confirmation email.
  • Tick the box to denote acceptance of Terms and Conditions and College Rules. I consent to my submitted data being collected and stored in accordance with GDPR guidelines.
  • € 0.00
  • If you are not paying the deposit today by credit card, further instructions for alternative payment methods will be emailed to you after submitting this form.

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CONTACT US

Coláiste Chonnacht,
An Spidéal,
Co. na Gaillimhe.
Phone:  091 553146
Mobile: 087 1000710
Email: eolas@colaistechonnacht.com

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