Services & Supports

Admissions Office

Mature Students Online Application Form

This form is also available in Irish: Foirm iarratais do mhic léinn lánfhásta
( * indicates required information)

Personal Information

Date applied to CAO:

CAO Number:

Surname*:

First Names*:

Home Address:

Daytime Telephone Number:

Mobile Telephone Number:

E-Mail Address:

Gender: Male Female

Date of Birth:

Country of Birth:

Nationality:

Course Title and CAO Code

(you must apply to the CAO before February 1st)

NUI Maynooth courses for which you wish to be considered in order of preference.
(Please consult the NUI Maynooth Prospectus):

(1) *

(2)

(3)

(4)

(5)

(6)

(7)

(8)

Note: It is essential that you also submit an application to the CAO not later than 1st February.

Forms are available from Central Applications Office, Tower House, Eglinton Street, Galway, ph. 091-509800, or you can apply online at www.cao.ie

Education

Last Second Level School Attended (if any):

Attended From: Attended Until:

Address (including country):

Last Second-Level examination taken:

Title of Exam:

Year taken:

Please enter the results of the last second-level examination you have taken in the boxes below if applicable (e.g. either Junior / Intermediate Certificate or Leaving Certificate)

Result 1

Subject: Year: H/O: Grade:

Result 2

Subject: Year: H/O: Grade: Result 3

Subject: Year: H/O: Grade: Result 4

Subject: Year: H/O: Grade: Result 5

Subject: Year: H/O: Grade: Result 6

Subject: Year: H/O: Grade: Result 7

Subject: Year: H/O: Grade: Result 8

Subject: Year: H/O: Grade:

Current Education:

If you are currently taking a course please fill in the details below

Title (Leaving Cert, Junior Cert, GCSE, FETAC, BTEC,

Return to Learning, University, Institute of Technology,

Post Leaving Certificate etc.)

Previous Education Completed

(Starting with most recent)

Previous Education 1

Name of Institution:

Course Title:

From: To:

National Framework Qualification Level (if known):

Qualification Achieved:

Previous Education 2

Name of Institution:

Course Title:

From: To:

National Framework Qualification Level (if known):

Qualification Achieved:

Previous Education 3

Name of Institution:

Course Title:

From: To:

National Framework Qualification Level (if known):

Qualification Achieved:

Employment

Please list your most recent employment first:

Employment 1

From: To:
Employer Name & Address :

Job Title & Brief Description:

Employment 2

From: To:
Employer Name & Address :

Job Title & Brief Description:

Employment 3

From: To:
Employer Name & Address:

Job Title & Brief Description:

Additional Information

(NB - to separate your paragraphs please hit enter/return)

Describe in no less than 200 words the reasons why you want to pursue a degree at NUI Maynooth:*

(NB - to separate your paragraphs please hit enter/return)

Which aspects of your first choice course interest you most? (no less than 200 words)?

Briefly outline your interests, hobbies and any other activities:

Please provide any further information that you feel may be relevant to your application. (e.g. specific needs due to health / disability):

Referee 1

Please give the names, addresses and telephone numbers of two people (not related to you) who are willing to provide us with information in support of your application e.g. employer, teacher etc

Two Referees

Name:

Job Title/Profession:

Address:

Phone:

Referee 2

Name:

Job Title/Profession:

Address:

Phone:

Declaration

I declare that the information given by me in this application is true and accurate and that if I am admitted as a student I will abide by the regulations of NUI Maynooth.

The University reserves the right not to consider applications, and to cancel any offers of places where requested information has not been supplied or where falsified or misleading information has been supplied. If I have a criminal conviction(s) I have complied with the requirements as set out in the University's policy for applicants with criminal convictions at www.nuim.ie/admissions

You must tick the box to agree:

SUBMIT APPLICATION ON-LINE NOW:

Last edited: Tuesday, 31-Jan-2012 16:09:52 GMT

Admissions Office, NUI Maynooth, Maynooth, Co. Kildare, Ireland.
Tel: +353 1 7083822 | Fax: +353 1 7084614 | E-mail: admissions@nuim.ie

National University of Ireland, Maynooth

Services & Supports

Admissions Office

Mature Students Online Application Form

Course Title and CAO Code

Current Education:

Previous Education 1

Previous Education 2

Previous Education 3

Employment

Additional Information

Referee 1

Declaration