COISTE CHONTAE THÍR EOGHAIN
Coiste Cultúir agus Teanga
Scoláireachtaí Gaeltachta 2016 / Gaeltacht Scholarships 2016
Ainm / Name _________________________________________________________________________
Dáta breithe / Date of birth ____________________________________________________________
Cumann / Club ________________________________________________________________________
Uimhir Ballríocht / Membership Number ___________________________________________________
Seoladh / Address __________________________________________________________________
__________________________________________________________________
Telephone number ____________________________________________________________________
Scoil / School __________________________________________________________________
Name to which cheque should be made payable_____________________________________________
Áit ar an gcúrsa Gaeltachta / Gaeltacht location _____________________________________________
Dátaí an Chúrsa / Dates of the course _____________________________________________________
Contact details for college (rúnaí, address & phone number) to confirm acceptance/attendance on course.
____________________________________________________________________________________ ____________________________________________________________________________________
Síniú Rúnaí Chlub / Club Secretary’s signature ____________________________ Dáta / Date ________
Parent / Guardian Signature ___________________________________________ Dáta / Date ________
Dáta a fuarthas / Date Received___________________________
Forms must be submitted to Tyrone GAA, 230 Radergan Road, Garvaghey, Dungannon,
Co Tyrone, BT70 2EH. Closing date – Friday 13th May. Presentation of cheques Wednesday 8th June in Garvaghey. Essential information – ALL applications must be signed by Cathaoirleach, Rúnaí/Leas Rúnaí, Cisteoir nó Oifigeach Ballraíocht of the club.
Only those members with a valid registration number, paid up before application received may be deemed eligible. Unfortunately due to the membership clause grant applications cannot be considered from members of the camogie or ladies associations.
Late or incomplete forms will not be processed
