( * question MUST be answered ) ( ** question must be answered by Irish Nationals)
 Name (as you wish it to appear on all official University records):
 Surname * :
 First Names * :
 
Date of Birth * :  /   / 
 PPS Number ** :
 
 Gender * :  Male Female
 Medical Condition/Disability Difficulty * :  Yes No   (If you selected yes please click )
 
 Address  * : Ireland Other Country
 
 
 
 
 
 Main Contact Number * :
 Mobile Telephone:
 Work Telephone:
 
 Country of Nationality * :
 Country of Birth * :
 
 Most recent Educational Institution Attended * : 
 
 Applicant's Current Status * :  Undergraduate Graduate
 
 University / Subject choices   
 
 Please ensure that the Universities you are applying to actually offer modules in the particular subject(s)
 you intend to teach.
 
 Please select the university / universities from the list below for which you wish to be considered.
  It is important to note, you’re NOT listing your preference here.
 
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 Please select your proposed Teaching Subjects which must be taken to Degree level.
 Tip:
Hdown `ctrl` key (PC) or ‘command’ key (Apple) to select multiple subjects (max=2).
 
 
 
 
 Based on your degree subjects, the following courses choices are available to you
 to choose from in genuine order of preference. Please enter `1` in the preference
 box beside your preferred first choice and continue with the other available choices
 (e.g. `2` for your second choice, `3` for your third and so on)

 Please focus on the university when selecting your preferences as opposed to the subjects.
 
    Preference    Course Code    Subject & University Names
                          
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