Junior Cycle - Religious Education

 

Professional Development Service for Teachers

Religious Education Support

 
 

 


 

 

Course Registration form

 

Closing date for application is one week before the commencement of each course

 

 

Photocopy as necessary  -  One applicant per form

 

 

Name:  _______________________________________________________________________

 

 

Mobile Number: ______________________________________________________________

 

 

E-mail:  ______________________________________________________________________

 

 

School Name:  _______________________________________________________________

 

 

School Address:  ____________________________________________________________

 

 

_____________________________________________________________________________

 

 

School Phone/Fax:  __________________________________________________________

 

 

School Email: _______________________________________________________________

 

 

School Roll No:  ____________________________________________________________

 

 

Title of Cuurse: ____________________________________________________________

 

 

Course Venue:  ___________________________________________________________ (Education Centre)

 

 

Date of Course:  ___________________________________________________________

 

 

Applicants Signature: ______________________________________________________

 

 

Application Date:  __________________________________________________________

 

 

Teaching Council Number: _________________________________________________

 

Please indicate below whether or not you are teaching Junior Certificate Religious Education or Leaving Certificate Religious Education for State examination:

 

I teach Junior Certificate Religious Education for examination        Yes                        No    

 

I teach Leaving Certificate Religious Education for examination     Yes                        No 

 

Please complete, sign and return this form to Angela Thompson (R.E. Administrator), Co. Wexford Education Centre, Milehouse Road, Enniscorthy, Co. Wexford or email to angelathompson@pdst.ie  or fax to 053 923913

 

Data Protection: The Department of Education and Skills will treat all personal data you provide on this form as confidential and will use it solely for the purpose intended. The information will only be disclosed as permitted by law or for the purposes listed in the Departments registration with the Data Protection Commissioner - REF 10764/A