ST PATRICK’S COLLEGE
(A College of Dublin City University)
DRUMCONDRA
DUBLIN 9

Tel +353 1 884 2096/2025		
COLÁISTE PHÁDRAIG
(Coláiste de Chuid Ollscoil Chathair Bhaile Átha Cliath)
DROIM CONRACH
B.Á.C. 9

Tel +353 1 884 2096/2025	

St Patrick’s College & Mater Dei Institute invite Application for admission to
Masters in Religious Education (Primary)

Please complete this form and return, together with relevant supporting documentation, to the
Admissions Office, St Patrick’s College, Drumcondra, Dublin 9, on or before 10th June, 2014

PLEASE ENSURE YOU ENCLOSE THE FOLLOWING WITH YOUR COMPLETED APPLICATION FORM:

•	Certified copy of academic transcript (copies of conferral parchment will not be accepted, photocopies will not be accepted)
•	Passport Photo (Affixed)
•	Application Fee €30.00 (non refundable)
•	Please supply two written references – one to be academic & one to be character

____________________________________			__________________________________________	 
Last Name							First Name			           

__________ / __________ / ____________			__________________________________________
Date of Birth							Nationality

___________________________________________________________________________________________________
Postal Address

_______________________   __________________________          ______________	__________________________
Home Tel No		      Mobile No				Email Address

Please affix photo here

One year duration

or                                          	

Two year duration

REFERENCES: Please supply two written references – one to be an Academic Referee and one character
Reference 1: Academic	Reference 2: Non Academic	
Name
	Name	
Position
	Position	
Address
	Address	
Tel No
	Tel No	
Email Address	Email Address

References should be current and sent separately to the Admissions Office, St Patrick’s College, Drumcondra, Dublin 9

HIGHER EDUCATION: (University or other Third Level Institutions)
Please give details of all undergraduate and postgraduate qualifications obtained to date and include details of courses to be completed in the year of application (please use separate sheet if required)

Title of Award	Subjects	Institution	Years of Study	Overall Result	

					

FINAL YEAR UNDERGRADUATES: Please provide details of undergraduate course currently being pursued, together with results to date.

Programme B.A./B. Ed.	Subjects	Institution	Years of Study	Overall Result	

					

OTHER QUALIFICATIONS: / Computer Skills – please use separate sheet if required

WORK AND/OR OTHER RELEVANT EXPERIENCE: please use separate sheet if required
		
Type of Work	Dates   From/To	Employer where appropriate	

			

			

			

			

PLACE OF BIRTH: _____________________________  COUNTRY OF BIRTH	: _______________________________

COUNTRIES OF RESIDENCE	Please indicate below the countries in which you were ordinarily resident for the 5 years preceding the date of this application:

Country:	From:	To:	

			

ENGLISH LANGUAGE COMPETENCY

Is English your first Language?      Yes 	         No	 If “No” what is your first Language?  _______________

Evidence of competency in English (only to be filled by those applicants whose first language is not English):
How many years of education and at what level (primary, secondary or higher) did you complete through the medium of English?

Examination	Level Required	
Irish Leaving Certificate English	Ordinary Level Grade D3	
GCE A-Level English Language	Grade D	
IELTS	Composite score of 6.5 or above, with no less than 6.0 in any one component	
TOEFL	213 (computer-based)
550 (paper-based test)	
Toefl iBT	Total Score of 80	
Cambridge Certificate of Proficiency in English	Grade C	
Cambridge Certificate of Advanced English	Grade B	
English Test for Academic and Professional Purposes (ETAPP)	C1	

In certain circumstances, results in examinations other than those outlined above may be accepted as proof of competence in the English language.  This is the case, for example, for students who have successfully achieved Grade D or higher in examinations which are deemed by St Patrick’s College to be the equivalent of GCE A-Level examinations and non-native speakers of English who have completed their education through the medium of English.  Please include the details of any English language examinations and proof of successful completion when applying to St Patrick’s College.

(Non-native speakers of the English Language only):

Examining Body e.g.
IELTS, TOEFL, Cambridge Proficiency	Expected Completion Date	Score	

			

ANY OTHER INFORMATION YOU CONSIDER RELEVANT MAY BE NOTED HERE:

DECLARATION:
I certify that the information given above is correct and I hereby undertake, if admitted to the programme, to observe all the regulations of St Patrick’s College/Mater Dei Institute and Dublin City University.

______________________________		__ __  /  __ __  / __ __ __ __
Applicant’s Signature					Day	   Month     Year	

Please Note:

•	Short-listing may apply and short-listed candidates may be interviewed as part of the selection process

•	Incomplete application forms will not be accepted

•	Student may pursue only one course of study in St Patrick’s College at any given time

•	Written references must be supplied