Postgraduate Studies Application Form Page
    * question MUST be answered   ( ** question must be answered by Irish Nationals)
 
Surname *:
First Names *:
 
 Name under which Primary Degree conferred (if different from above):
Surname:
First Names:
 
Date of Birth *:  /   / 
 
Gender *:  Male Female
 
Medical Condition/Disability *:  Yes No   (If you answered yes click )
 
Correspondance Address *: Rep. of Ireland Other Country
 
 
 
 
 
Main Contact Number *:
Mobile Telephone:
Work Phone:
International Agents Name
(if applicable):
International Agent's e-mail address:
Confirm International Agent's e-mail:
 
Country of Nationality *:
Country of Birth *:
 
Most recent Educational Institution Attended *: 
Applicant's Current Status *: 
Current Maynooth University Student
Maynooth University Graduate
Other Applicant
 
Maynooth University Student Number
(if applicable):

Important note for Irish Aid Fellowship applicants
If you are an approved Irish Aid Fellowship applicant, please enter code:  
ICOS will arrange payment of the application fee on your behalf.
 
 RESEARCH PROPOSAL
 (You may only make one programme choice)
 
 To lookup course codes, click here
 
* Programme Code:
 
* Proposed Start Date:
 
* Proposed Title: 
* Proposed Topic: 
 * Have you discussed the proposed topic with a member of the relevant Department?   Yes  No
If yes, select Department:     
If yes, select Member name:
  If your Department member name is not listed, please email postgrad.dean@nuim.ie to request your member name is added.
 
*  Have you received Scholarship Funding for this programme?   Yes  No
*  Is research to be conducted by Distance Mode?  Yes  No
*  Details of Host institution or company: 
*  Proposed Supervisor of Host institution or company: 

 
 
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