1. Information required for registration

We are considering providing a class for students taking Russian for Leaving Certificate in 2019. If the classes go ahead they would take place in Limerick city. We would 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. We will let you know as soon as a decision is made. 

Name:

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* 1. Name:

School:

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* 2. School:

Date of Birth:

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* 3. Date of Birth:

Email address:

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* 4. Email address:

Telephone number:

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* 5. Telephone number:

Country of Origin:

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* 6. Country of Origin:

Language/s spoken at home:

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* 7. Language/s spoken at home:

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

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

In what year are you taking the Leaving Cert Russian exam?(Classes only open to those going into 5th Year in September)

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* 9. In what year are you taking the Leaving Cert Russian exam?(Classes only open to those going into 5th Year in September)

Where did you hear about this class?

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* 10. Where did you hear about this class?

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