|
Is féidir an
leathanach seo a chur i gcló, é a líonadh agus a chur
chugainn (sonraí
anseo).
Cuir
tic sa bhosca cuí / Please tick appropriate
box.
| Deireadh
Seachtaine: |
|
Dátaí/
Dates |
.................................. |
| Cúrsa
Seachtaine: |
|
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……………………………….
|
