* I have made contact with the Head of Department/Supervisor to discuss my proposed research topic(s)? Yes No    
If no, you will not be able to proceed with your application.
   Please refer to the WIT website to arrange to discuss your Research topic.   
  * question MUST be answered    ** question for Irish Nationals only
 
 * Name (as you wish it to appear on all official Institute records):
Surname:
First Names:
Title:
 
  Name as on Birth Certificate(if different from above): 
 Surname:
 First Names:
 
 * Date of Birth:  /   / 
 
 * Gender:  Male Female
 
 * Medical Condition/Disability/Specific Learning Difficulty:  Yes No
 
 * Home Address: Ireland Other Country
 
 
 
 
 
 * Correspondence Address: If SAME as above, please tick here   
  Ireland Other Country
 
 
 
 
 
 * Main Contact Number:
 Mobile Telephone:
 Work Telephone:
 
 Skype ID:
 
 (Enter International Agent's details if applicable)
 International Agent's name:
 International Agent's e-mail address:
 Confirm International Agent's e-mail:
 
 * Country of Nationality:
 ** PPS Number:
 * Country of Birth:
 
 * Most recent Educational Institution Attended:   
 
 * Applicant's Current Status: 
Current WIT Student
WIT Graduate
Other Applicant
 
 WIT Student Number
(if applicable):  		 
 

 Important note for sponsored applicants
  • If you are an approved Irish Aid Fellowship applicant and have a sponsor code from ICOS
  • or have a sponsor code from International Office in WIT
      Please enter code:  
      ICOS/WIT will arrange payment of the application fee on your behalf
 
 RESEARCH PROPOSAL   
 
 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, enter Supervisor`s name:
  Please email pgadmissions@wit.ie if you are unsure of your supervisor`s name.

 
 
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, enter Supervisor`s name
  Please email pgadmissions@wit.ie if you are unsure of your supervisor`s name.

 
 
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, enter Supervisor`s name
  Please email pgadmissions@wit.ie if you are unsure of your supervisor`s name.

 
 
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, enter Supervisor`s name
  If your Department member name is not listed, please email pgadmissions@wit.ie to request your member name is added.

 
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