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leagan Gaeilge

for adults for adults for young people for young people for young people
for adults for young people


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Please tick appropriate box.

Weekend:
 
Dátaí/ Dates ..................................
Weeklong:
 
Dátaí/ Dates ..................................
Ainm
(Name)
___________________________________
Seoladh
(Address)
___________________________________
Seoladh
(Address)
__________________________________
Guthán
(Phone)
___________________________________
Aois
(Age)
___________________________________
Gnéas
(Gender)
___________________________________
Dátaí a d'oirfeadh dom
(Dates suitable for me)
___________________________________

An bhfuil seomra singil uait? Tá (Yes) ............ Níl (No) .............
(Do you require a single room?)

Ar fhreastail tú ar Chúrsa(í) Gaeilge ó d'fhág tú an scoil?
Have you attended courses or classes since leaving school? ___________

Má d'fhreastail, tabhair sonraí
(If so, please give details) ______________________________________

I do bharúil féin, cén caighdeán Gaeilge atá agat?
(What standard of Irish, in your opinion, do you have?)

Measartha maith
(Reasonably good)
 
Bunúsach
(Basic)
 
Tosnaitheoir
(Beginner)
 

Síniú / Signed ..........……………………………….

Dáta……………………………….