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*Animation FoundationAnimation HND 1Animation HND 2Architectural Design & Technology FoundationArt & Design Portfolio PreparationCafé& 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 2Creative Writing for Digital MediaEarly Childhood Care & Education BTEI- Year 1Early Childhood Care & Education BTEI- Year 2Early Childhood Care & Education L5Early Childhood Care and Education L6Engineering TechnologyEntrepreneurship in Creative Industries- VTOSESOL & Employability Skills- VTOSFashion Design 1Fashion Design 2Film Production HND 2Film Production HND1IT Technician (Pre-Apprenticeship) 1General Education- VTOSGraphic Design FoundationGraphic Design HND 1- Visual CommunicationsGraphic Design HND 2- Visual CommunicationsHairdressingHealth Science -Physiology & SportHealth Science -Pre-NursingHealth Service Skills - VTOSHealth Service Skills- BTEI Year 1Health Service Skills- BTEI Year 2Health Service Skills- Physiotherapy AssistantHorticulture-VTOSInterior Design HND1Interior Design HND2Journalism HND 1Journalism HND 2Media Production FoundationMedia Production HND 1Media Production HND 2Medical Laboratory Science HND 2Outdoor Adventure Management HND 1Outdoor Adventure Management HND 2Outdoor RecreationPerforming Arts HND 1Performing Arts HND 2Photography Level 6Pre-Primary School TeachingPre- University Science- DCUPre-University Science-QQIPreliminary EngineeringSocial Care Level 5Social Care Level 6Theatre Studies– FoundationTelecoms (Field Technician)Tour GuidingTourism with Business & Marketing 1Tourism with Business & Marketing 2Youth Activities WorkerName* First Last Date of Birth* GenderMaleFemaleAddress* Street Address City ZIP / Postal Code Mobile Phone Number 1*Phone Number 2Email Address* NationalityDisability Information*Tick the boxes below to indicate the disability. Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder Blind/Vision Impaired General Learning Difficulty/Acquired Brain Injury Neurologically-based Speech, Language and Communication Disorder Physical/mobility Specific Learning Difficulties: Dyscalculia & Dysgraphia Specific Learning Difficulties: Dyslexia Autistic Spectrum Disorder (including Asperger’s syndrome) Deaf/Hard of Hearing Mental Health Condition Neurological Condition Significant Ongoing Illness (Epilepsy, Diabetes, Cystic Fibrosis, other) Specific Learning Difficulties: Developmental Co-ordination Disorder (Dyspraxia) Difficulty with reading and writing Numeracy issues Other (please give details)Other*Please give details of your disabilityIMPACT - Please describe how the disability/medical condition/learning difficulty impacts on your ability to study and participate in a course?*Evidence of disability:The College requires documentation from an acceptable professional source that verifies your disability. Please indicate the documentation you can provide to the college. 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 OtherFor Dyslexia Only For Dyslexia OnlyEducational Psychologist report* Yes NoWhat school were you in when your last report what done?* Primary School Secondary SchoolThe Learner and Disability Support Services in the college are provided by National Learning Network. Information on this form will be shared with National Learning Network. This iframe contains the logic required to handle Ajax powered Gravity Forms.