All information given to Student Support Services is treated confidentially. Student Status*I am currently studying in CDCFEI will be starting a course in SeptemberCourse*Select your course from list belowAdvanced Certificate in Art and Design L6Animation 1 FoundationAnimation 2 HNCAnimation 3 HNDArchitectural Design & Technology FoundationArt & Design Portfolio PreparationBarberingBarista Skills (BTEI)BIM with Project ManagementBiotechnologyBuilding ConstructionCafé& Deli Skills- BTEICertificate in Business 1Certificate in Business 2Community Development 1- VTOSCommunity Development 2- VTOSComputer Networking Technologies Yr 1Computer Networking Technologies Yr 2Computer Science 1Computer Science 2Conflict ResolutionCraft Production (Pottery for Beginners) L5Craft Production- VTOS level 5Craft Production- VTOS level 6Creative Writing for Digital MediaEarly Childhood Care & Education BTEI- Year 1Early Childhood Care & Education BTEI- Year 2Early Childhood Care & Education L5Early Childhood Care and Education L6Ecotourism with adventure ActivitiesEngineering Technology Pre-apprenticeshipEnglish for Speakers of Other Language ESOL-VTOSEntrepreneurship in Creative IndustriesEntrepreneurship in Outdoors (Shackleton 3)Fashion Design 1Fashion Design 2Film Production 1 HNCFilm Production 2 HNDFloristryIT Technician (Pre-Apprenticeship) 1General Education- VTOSGraphic Design 1 - Visual CommunicationsGraphic Design 2- Visual CommunicationsHairdressing Pre ApprenticeshipHealth and SafetyHealth and Wellbeing Programme-BTEIHealth Science -Pre-NursingHealth Service SkillsHealth Service Skills- BTEI Year 1Health Service Skills- BTEI Year 2Horticulture-VTOSIllustration & Visual Storeytelling L6Inclusive Education & training L6Interior Design 1Interior Design 2Journalism and New MediaJournalism 1 HNCJournalism 2 HNDMedia Production Foundation (Media 1)Media Production HNC (media 2)Media Production HND (media 3)Mural Urban Art-BTEIMedical Laboratory Science HND 2National Hairdressing ApprenticeshipNutrition & Lifestyle CoachingOccupational Therapy AssistantOutdoor Adventure Management L5 1 (Shackleton 1)Outdoor Adventure Management 2 L6 (Shackleton 2)Performing Arts HNCPerforming Arts HNDPhotography Level 6Physiotherapy Assistant (Health Service Skills)Podcast-BTEIPottery for Beginners-BTEIPre-Primary School TeachingPre- University Science- DCUPre-University PsychologyPre- University Science-Lab TechniquesPre-University Sports SciencePreliminary EngineeringProduct DesignRehabilitation, Sport & ExerciseSocial Media InfluencerSocial Care Level 5Social Care Level 6Speech and Language Therapy AssistantTour GuidingTourism with Marketing 1Tourism with Marketing 2Traineeship in logistics with forklift licenceTraineeship in Outdoor EducationTraineeship in School and College AdministrationTraineeship in Tourism and HospitalityYouth Activities WorkerName* First Last Mobile Phone Number 1*Phone Number 2Email Address* Disability Information*Tick the boxes below that apply to you Attention Deficit Disorder ADD, Attention Deficit Hyperactivity Disorder ADHD Autistic Spectrum Disorder (ASD) (including Asperger’s syndrome) Blind/Vision Impaired Deaf/Hard of Hearing Developmental Co-ordination Disorder (Dyspraxia) Dyscalculia & Dysgraphia Dyslexia General Learning Difficulty/Acquired Brain Injury Mental Health Condition Neurological Condition Physical/mobility Speech, Language and Communication Disorder Significant Ongoing Illness (Epilepsy, Diabetes, Other) Difficulty with IT and computer Skills Difficulty with Reading and Writing Difficulty with Maths Other (please give details) Other*Please give details of your disabilityRecord supports you availed of in your previous school/ education experience. SNA/ESW Full time SNA/ESW Part-time or shared Resource hours Technology Transport Evidence of disability:A copy of these documents should be uploaded to the Disability Evidence Folder in your MIT account. This will be held securely. Audiologist/ ENT report Consultant Letter from the School for the Deaf or Blind Neurologist Occupational Therapist Ophthalmic Surgeon Psychiatrist Psychologist Speech and Language therapist No Documentation Available Other The College requires official documentation about your disability. Please indicate the documentation you can provide.All disclosures to the Learner and Disability Support Services in the college will be treated confidentially. Services are provided by National Learning Network. Information on this form will be shared with National Learning Network.