ICHAS Application Form

Application Form - HSE Staff

Please note that the "*" denotes a mandatory field.

Name:*

Forname

Surname

Address:

Street Address Street Address Line 2 City/Town County Postal / Eir Code Country

PPS Number*

Phone:

Area Code

-

Phone Number

Mobile:

Area Code

-

Phone Number

Nationality*

Country of Birth

Nationality

Date of Birth*

day

/

month

/

year

Gender*

Male

Female

E-mail:*

Please contact the college if you do not have a valid email address.

Course or Programme you wish to apply for:*

Preferred Location*

Have you completed or are currently studying on another ICHAS Course

Yes

No

Previous ICHAS Course/Modules:

Photo ID

A passport style photo is required for your student record and to create your ICHAS Student ID Card.

Upload your Photo (5Mb Max)here:

1/4

(e.g. School, Post-Leaving Certificate, FAS, College or University)

Some programmes offered by ICHAS have particular entry requirements and applicants are advised to refer to the prospectus or website for any recommendations regarding prior learning or experience. The information in this section will allow us to determine if you may be entitled to any exemptions or credit allocation based on prior learning.

Educational Qualifications

(University, College, Institute of Technology, Post Leaving Cert, C&G, FAS etc.)

Name of Institute/College

Name of Institute/College(2)

Name of Institute/College(3)

Name of Institute/College(4)

Name of Institute/College(5)

From - To (mm/yy)

From - To (mm/yy) (2)

From - To (mm/yy) (3)

From - To (mm/yy) (4)

From - To (mm/yy)(5)

Course/Programme

Course/Programme(2)

Course/Programme(3)

Course/Programme(4)

Course/Programme (5)

Qualification/Result

Qualification/Result(2)

Qualification/Result(3)

Qualification/Result(4)

Qualification/Result (5)

Upload Results/Transcripts

Important:

Please upload copies of certified results for all Qualifications/Results mentioned above. Applicants for Level 8 & 9 programmes must upload transcripts.Results of relevant examinations to be taken/courses yet to be completed should also be uploaded (can be submitted at a later date).

Employment Record

Please provide details of employment, internship, or volunteer work that you feel might be relevant to your application

Employer/Organisation

Employer/Organisation(2)

Employer/Organisation(3)

Employer/Organisation(4)

Employer/Organisation(5)

Employed From - To (mm/yy)

Employed From - To (mm/yy) (2)

Employed From - To (mm/yy) (3)

Employed From - To (mm/yy) (4)

Employed From - To (mm/yy)(5)

Position/Role

Position/Role(2)

Position/Role(3)

Position/Role(4)

Position/Role(5)

Please indicate the reasons why you wish to pursue a Degree with ICHAS. You should state all information that may be relevant to your application, e.g. previous experience, volunteer work, reasons for your interest in your chosen subject area etc.

You may also upload your Statement as a separate document:

Statement

Special Requirements

ICHAS makes every effort to accommodate learners with disabilities, whether physical, learning or otherwise. Such applicants are invited to contact the Administration Office in writing with details of the nature and extent of the disability. The application will be handled in line with ICHAS’ Equality Policy and any disclosure will not adversely affect the application. This will allow us to give you the best advice prior to application.

Elements of some modules may be delivered through our Blended Learning Environment incorporating online/web based interactive learning. This means students will engage with some learning through face to face sessions and additional learning will be delivered through a virtual learning environment supported by highly qualified lecturers. In order to use web based interactive learning resources, you will require access to a suitable desktop or laptop computer, and access to the Internet. Minimum IT requirements are listed here. Please see the online Blended Learning FAQ for further information.

Please tick the box to confirm that you understand this requirement:*

I understand

Declaration

I declare that I have read and agree to the Terms and Conditions and that the information given by me in this application is true and that if I am admitted as a student I will abide by the regulations of the Irish College of Humanities and Applied Sciences. ICHAS reserves the right not to consider applications and to cancel any offers of places where requested information has not been supplied or falsified; or misleading information has been supplied.

Tick this box to digitally sign this declaration:*

Sign

Type Signature:*

Date:*

Form Verification:

ICHAS Application Form – HSE