1. Information required for registration

We really appreciate you taking time to fill out this page which will not only help us in the administration and organisation of these classes but will also help us to understand your needs. You must complete all questions.

* 1. Name:

* 2. School:

* 3. Date of Birth:

* 4. Email address:

* 5. Telephone number:

* 6. Name of parent/guardian

* 7. Contact telephone number for Parent/Guardian

* 8. Contact email address for Parent/Guardian

* 9. Country of Origin:

* 10. Language/s spoken at home:

* 11. Reason/s for wanting to take a Leaving Cert class in Russian:

* 12. Please describe your level of Russian.

* 13. In what year are you taking the Leaving Cert Russian exam?

* 14. If we provide this class are you committed to attending on a regular basis?

* 15. Where did you hear about this class?

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