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Transition Year Placement: Expression of Interest
Name:
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Your answer
Date of Birth: - Note all applicants must be at least 16 at time of placement.
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MM
/
DD
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YYYY
Home Address:
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Your answer
Phone number:
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Your answer
Email address:
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Your answer
Do have any medical conditions or additional needs we should be aware of? This information will be treated in the strictest of confidence.
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Your answer
Name, relationship to, and phone number of your emergency contact. e.g Mary Murphy, Mother, 083 1234567:
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Your answer
Name of current school:
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Your answer
Name and contact details of TY coordinator:
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Your answer
Dates of Placement:
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Your answer
Are you a past pupil of Tullyallen N.S.?
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Yes
No
Do you/or have you had siblings/ family members e.g. brothers/sisters in Tullyallen N.S. If yes, give details.
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Your answer
You understand that you need to be Garda vetted before you can undertake a placement in Tullyallen N.S. This can take up to 6 weeks to process. Tullyallen N.S is not involved in the process and will not accepted unvetted candidates.
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I understand
You understand that completing this form DOES NOT guarantee a placement in Tullyallen N.S.
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I understand
You understand that you will have to sign a form of undertaking and will be expected to act appropriately at all times. Failure to do so may result in the placement being terminated.
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I understand
I declare that all of my responses have been honest and truthful.
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Yes
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