Repeat / Deferred Examination Registration Form January 2015 Name: ............................................................................ Phone: ..................... ID Number: ............................................................................ Fulltime Course: ........................................................................... Code: ..................... Year: One  Five  BLOCK CAPITALS Two  Three  Four   Accs  PLEASE TICK It is your responsibility to familiarise yourself with the Examination Timetable. EXAMINATION TIMETABLES WILL NOT BE GIVEN OUT OVER THE TELEPHONE. Timetables will be available from the Institute notice boards and from our web page: WWW.ITTDUBLIN.ie INSTRUCTIONS Please list clearly all subject titles you intend repeating (as on your transcript) in the appropriate column. · Please specify the semester in the appropriate column. · Complete and return this form, signed, to the Registrar’s Office (Room 120) ITT Dublin, Dublin 24, and pay the th standard charge of €65 no later than 5 December 2014. Payment must be made online via our website at http://www.ittdublin.ie/onlinepayments/fees/ · If you are repeating Continuous Assessment ONLY, you should contact your School office for details. Please list the subject below and mark ‘YES’ in the appropriate column. Repeat Examination fees: A standard charge of €65 for full and part-time students · Repeat Exams - Failure to make payment AND return this form by 5th December 2014 will incur a late fee penalty. Deferred Exams - Failure to return this form by 5th December 2014 will incur a late fee penalty. Late fee = €65 Examination Dates: 8th January – 17th January 2015 Subject Semester 1,3,5,7,9 Winter Semester: (1, 3, 5, 7, 9) 1st Attempt (Previous Repeat Exam Deferred Subject) 1. 2. 3. 4. 5. 6. 7. 8. Signed: __________________________________________ Date: _______________ Repeat CA Both Office Use only Form received: ......................................... Banner updated: .............................. Fee assessed and giro issued (Y / N) .................... Amount issued: ............................... Signed: ....................................................................................................................................... Date: .......................................................................................................................................