Coláiste Acla Booking Form

Please print out, fill in and sign this form and post along with the deposit payment to:

Coláiste Acla
Acaill
Co. Mhuigheo

Ainm/Name of Student

  
Seoladh/Address

 

 
Fón/Phone No.
  

Scoil/School
Rang/Class

  

Buachill/Boy

Cailiín/Girl
(Please tick one)

Aois/Age:

Date of Birth:

Medical Conditions:

Cara/Friends:

 

 

Select Course Date:

Cúrsa A

Cúrsa B

Cúrsa C

Cúrsa D

Cúrsa E

Cúrsa F

 

01/06/08 - 15/06/08

15/06/08 - 29/06/08

29/06/08 - 13/07/08

13/07/08 - 27/07/08

27/07/08 - 10/08/08

10/08/08 - 24/08/08
Full Fee

Deposit

Balance (Payable by 01/04/2008)

Travel (return to Lucan)

€800

€300

€500

€50


I agree to be bound by the rules of Coláiste Acla

Signed

As parent/guardian of

Please make cheques or postal orders payable to: Coláiste Acla, Acaill, Co. Mhuigheo