Bridgetown Vocational College Coiste Oideachais Ghairme Beatha Cho Loch gCarman College Principal Course Co-ordinator Fionnuala Greene Mairéad Redmond Please return this form to: Admissions Office, Bridgetown Vocational College, Bridgetown, Co. Wexford Personal Details Name: _________________________________________ Address: _________________________________________ _________________________________________ Home Telephone (landline): _________________________________________ Mobile Telephone: _________________________________________ Next of Kin: _______________ Contact No: _______________ PPS Number: _________________________________________ Medical Card Number: _________________________________________ Age: _____ Date of Birth: ___________________________ Last school attended School name _________________________________________ Address _________________________________________ Number of years in Post-Primary Education _____________________________ Examination Record List of subjects taken and grades achieved. If you sat your Leaving Certificate this year, tick the subjects taken and indicate level, i.e. Higher (H), Ordinary (O), or Foundation (F) Subject Level Result (if known) No result yet (studied this subject) (Traditional Leaving Certificate - Year _______ ) Accountancy [ ] Agricultural Science [ ] Art [ ] Biology [ ] Business Organisation [ ] Chemistry [ ] Construction Studies [ ] Engineering [ ] English [ ] French [ ] Geography [ ] History [ ] Home Economics [ ] Irish [ ] Maths [ ] Materials Technology [ ] Music [ ] Physics [ ] Technical Graphics [ ] [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] ] (Leaving Certificate Applied - Year ________ ) English [ ] French [ ] German [ ] Hotel & Catering [ ] Information Technology [ ] Irish [ ] Maths [ ] Metalwork [ ] Music [ ] Social Education [ ] Vocational Prep & Guidance [ ] [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] [ [ [ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] ] ] ] Other Post Leaving Certificate courses attended and/or other qualifications: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Bridgetown Vocational College Bridgetown, Co Wexford Phone: (053) 913 52 57 Fax: (053) 913 51 55 E-mail: [email protected] Website: www.bridgetownvocationalcollege.ie I undertake that, if accepted as a student of Bridgetown Vocational College, I will abide by the regulations and procedures of Co Wexford VEC and Bridgetown Vocational College. Signature of applicant ________________ Date ________________
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