National University of Ireland, Galway, Ireland

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* 1. I am planning to participate in the 

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* 2. Is the funding for your participation secured?

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* 3. Last name(s)

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* 4. First name(s)

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* 5. My preferred e-mail address

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* 6. Profession

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* 7. Name of school / institution / organization

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* 8. Invoicing address:
Please give the exact name and address to which the invoice will be drawn. The course fee is 350€ including tuition of  days and 700€ for 10 days. In addition, an administrative fee of 70€ will be applied, amounting to totals of 420€ and 750€
The invoice(s) will be sent out c. 5-6 weeks prior to the course start.

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* 9. Do you wish to avail of the accommodation option in the new Goldcrest student apartments on the university campus?  They are within easy access, 5-10 min. walk, to the training location at St. Anthony's.
The apartments have all necessary self-catering equipment, are cleaned daily, bed linen and towels are included in the price.  Rates given below are indicative but unlikely to change too much. Breakfast option is also available at c 7€ per day.

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* 10. Subject(s) / discipline(s) taught

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* 11. Age of students

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* 12. Experience in CLIL

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* 13. Please state three things that you wish to gain from this course

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* 14. If you have any special requirements (i.e. diet, allergy..), please specify them here.

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* 15. Any additional information you may wish to give, or questions you wish to pose to the course team.

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