Rang Gaeilge 2020-21
FOIRM CLÁRÚCHAIN na Cultúrlainne - Rang Gaeilge
Irish language class REGISTRATION FORM
Coláiste an Phobail - Cultúrlann Uí Chanáin      
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Email *
Ainm / Name *
Seoladh Poist / Address *
Uimhir Teagmhála / Contact number *
An bhfuil riachtanais foghlama faoi leith agat?  Do you have any special learning requirements? If so, please give details.
An íocann tú an táille laghdaithe nó an táille iomlán?   Do you pay the reduced or the full fee? *
LEIBHÉAL / LEVEL
MÚINTEOIR / TEACHER *
LÁ - DAY *
AM - TIME *
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