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 PreparationBarbering (BTEI)Building Information Modelling with Project Management (WBL)Cafe & Deli Skills with Barista (BTEI)Community Care (BTEI)Computer Networking Technologies Yr 1Computer Networking Technologies Yr 2Computer Science 1Computer Science 2Craft Production level 5Craft Production level 6Creative Writing for Digital MediaEarly Learning & Care L6 (BTEI)Early Learning & Care L5Early Learning & Care L6Engineering Technology Pre-apprenticeshipEnglish for Speakers of Other Language ESOL-(BTEI)Entrepreneurship-Start your own business BTEIeSport Media ManagementFashion Design & Styling 1Fashion Design & Styling 2Film Production 1 HNCFilm Production 2 HNDGeneral Education- VTOSGraphic Design 1 - Visual CommunicationsGraphic Design 2- Visual CommunicationsGeneral Learning Level 4 (BTEI)Hairdressing Pre ApprenticeshipHealthcare Pediatric Support (BTEI)History of Art & Architecture (BTEI)Horticulture (full-time)Horticulture Part-time (BTEI)Healthcare & Physiotherapy AssistantInclusive Education & training L6Interior Design 1Interior Design 2Journalism & Podcasting 1Journalism & Podcasting 2Logistics with Forklist Licence (WBL)Marketing & PRMedia Production Foundation (Media 1)Nursing Pre-UniversityNational Hairdressing ApprenticeshipOccupational Therapy AssistantOffice & IT Skills Level 4 (BTEI)Outdoor Adventure Management L5 1 (Shackleton 1)Outdoor Adventure Management 2 L6 (Shackleton 2)Performing Arts HNCPre-Unversity Business 1Pre-Unversity Business 2Professional FloristryPerforming Arts HNDPhotography Level 6Pottery for Beginners-BTEIPre-University Science MicrobiologyPre-University Science Environmental StudiesPre-Primary & Post-Primary School TeachingPre- University Science- DCUPre-University PsychologyPre- University Science-Lab TechniquesPre-University Sports SciencePreliminary EngineeringSport Rehabilitation and Exercise TherapySocial Care Level 5Social Care Level 6Social Media Content CreationSpeech and Language Therapy AssistantTraineeship in TV & Film Production (Media 2)Tour GuidingTourism with Business & Marketing 1Tourism with Business & Marketing 2Tourism & Hospitality (WBL)Traineeship- Entrepereneurship in the Outdoor (Shackleton 3)Youth Activities Worker (BTEI)Name* 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.