Junior Cert Application Form 2023/2024

PLEASE COMPLETE ALL QUESTIONS BELOW.
ALL OF THE INFORMATION PROVIDED WILL BE CONFIDENTIAL AND TREATED WITH UTMOST DISCRETION

STUDENT DETAILS

Surname(Required)

Name(Required)

Date of Birth(Required)

Postal Address(Required)

all correspondence will be sent to below address

Eircode(Required)

Student Mobile(Required)

Student Email(Required)

Enter Email Confirm Email

Are You on Facebook?(Required)

If no, please confirm that you will set up a Facebook account immediately(Required)

Yes

PARENT DETAILS

Surname(Required)

Name(Required)

Email(Required)

Regular emails / newsletters / correspondence will be emailed to this address

Enter Email Confirm Email

Mobile(Required)

Back Up Contact Name and Number(Required)

(in the event of us being unable to contact above parent)

We have read EF Parent and Student Pack including the EF Privacy Policy and agree to be bound by it(Required)

Yes

STUDENT WELL-BEING

(to be completed by PARENT only)

Does your child suffer from a medical condition or learning challenge or is currently undergoing evaluation for same?(Required)

(Medical conditions include Asthma, Diabetes, Epilepsy, peanut allergy etc. Learning challenges include dyslexia, dyspraxia, ADHD etc)

If YES, please provide us with the details below(Required)

Is there any other information that you feel is relevant to your child’s well-being?(Required)

(ie bullying / confidence issues / recent school move and why / personal family issues etc )

If YES, please provide us with the details below(Required)

STUDENT STUDY PROFILE

(to be completed by PARENT only)

Please give us a description of your child’s ability in French including weakest and strongest area(Required)

(ie has your child a natural ability for languages / does your child dislike French and if so, why?)

ACADEMIC RECORD

School(Required)

Name of French Teacher(Required)

Grade of 2nd Year summer French exam(Required)

Have you attended Essential French before?(Required)

If YES, please provide us with details(Required)

PAYMENT OPTIONS

Which payment option have you chosen for your child ?(Required)

Option A

Option B

Option C

NEW STUDENT ONLY

Do you have brothers or sisters who attended Essential French before?(Required)

Yes

Give Details - Name and Programme(s) Attended(Required)

Please give name and details (a phone number or an email address) of the person who recommended Essential French to you – specify ONE name only (it can not be your own parent’s name)(Required)

Provided you start the programme, the person you name above will receive a €30 Mahon Point Shopping Voucher for recommending us to you, as a “petit merci”

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