Foirm Iarratais / Application Form
Deireadh Seachtaine Gaeltachta (5ECT) / Gaeltacht Weekend (5ECT - Visiting Students)
21-23 Feabhra 2020 / 21-23 February 2020
    *Required information
*Ainm/Name:
*Seoladh/Address:
*Inscne/Gender:  Female
 Male
*Fón/Phone (Baile/Home):
*Fón/Phone (Mobile):
*Ríomhphost/Email:
*Uimhir Chlárúcháin OÉ, Gaillimh / Student ID number, NUI Galway:


*Please specify your accommodation preference:
Cara nó cairde ar mhaith leat seomra a roinnt leo (má bhaineann):
Friend or friends whom you would like to share a house with (if applicable):


An bhfuil aon riachtanais bia ar leith agat?
Do you have any special dietary requirements?

Táille & Eolas Breise / Fee & Further information

Ba chóir an táille cuí a íoc le Peigí Ní hOibicín, Seomra 103, Áras na Gaeilge roimh Dé hAoine 14 Feabhra 2020
Please pay the appropriate fee to Peigí Ní hOibicín, Room 103, Áras na Gaeilge before Friday 14 February 2020

Gach eolas eile ar fáil ó / Further information available from:
Peigí Ní hOibicín, 091-493616
peigi.nioibicinoegaillimh.ie

An spriocdháta chun d’iarratas a chur ar ceal ná Dé Céadaoin 19 Feabhra 2020.
The deadline for cancellation of your application is Wednesday 19th February 2020

Ní féidir aisíoc a fháil tar éis an dáta sin.
A refund will not be issued after this date.

Fágfaidh bus an Áirse, Ollscoil na hÉireann, Gaillimh ar 5 i.n. Dé hAoine 21 Feabhra, 2020.
The bus will leave the Archway (Quadrangle) NUI, Galway, at 5pm Friday 21 February, 2020.