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Application Form

Niall Smyth Memorial Bursary

– APPLICATIONS ARE NOW CLOSED FOR 2017 –

[ Niall_Smyth_Memorial_Bursary_2017 ] .PDF – Download and print off the application form, complete it fully and send it by post to Gerard Flanagan, Hon. Secretary SCC, Kylemore College, Ballyfermot, Dublin 10. Alternatively, you apply online below.

Online Application Form
Any information you supply is handled in strictest confidence and in accordance with our Privacy Policy. All sections must be completed. Uncompleted applications will be rejected by the SCC.

Please read the information guidelines on this website carefully before applying.

PLEASE NOTE CLOSING DATE: FRIDAY 17th February 2017.

PERSONAL DETAILS

Your Name (required)

Date of Birth (required)

Your Email (required)

Course of Study

Home Address

School Name and Address

Telephone - Home

Telephone - Mobile

SPORT / CULTURAL ACTIVITY DETAILS

Activity / Event

Level Reached

School / College

Club Society

County

Provincial

International

Other Representative

List of Achievements and Honours Gained

Programme of Tuition/Coaching/Training/Competition

Details of costs for which you you seek assistance

Any other relevant information

How did you hear about the SCC?

REFEREES

Please supply two referees. One from your school/college and one from your club or cultural activity director.

Referee 1:

Name

Address

Telephone

Email

Referee 2:

Name

Address

Telephone

Email

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