Part-Time Courses 2019 Application Form

Applications are now open for programmes commencing in September 2019.

* Indicates a mandatory field which must be completed

Campus Location

Please select which Lifelong Learning Centre you would like to apply to *:

Carlow Campus Wexford Campus Wicklow Campus

Programme Details

1st 2nd 3rd 4th

Personal Details

Please Note: The name you enter will appear on any parchment to which you may be entitled to.

Male Female

Please note: In this instance it is necessary to identify gender of the individual as, in registering a student on application, the software used by the Institute only activates the student registration when the gender of the applicant is identified in the system and verified by the applicant upon activation of the student card.

Yes No

Yes No

If yes please state:


The following information requested is for admission and statistical purposes only and will be treated in the strictest confidence.

Secondary School Irish University Irish Institute of Technology Post Leaving Cert College Other

Junior Certificate Leaving Certificate QQI/NCVA Apprenticeship Ordinary Degree Honours Degree PLC Qualification Masters Other

Proof of qualifications needs to be enclosed when returning application form to the Faculty of Lifelong Learning. If you are under 23 years of age, you will need to provide a copy of the Leaving Certificate or Full Level 5 qualification obtained.

Yes No

Yes No

Please Note: This information is required to ascertain what supports that you may require to facilitate you as a student.

Programme Fees

Please Note: Fees must be paid before commencement of programme. Once your application has been processed you will be contacted by Lifelong Learning with regards to making a payment.

If an organisation is paying part or all fees a letter on headed paper from that organisation must be attached to this application form indicating the amount of funding they will provide.

Yes No

Please Note: Programmes run subject to sufficient numbers. The types of programme offered are Major Awards leading to Degree, Masters, Diploma, Higher Certs (Certs of 60 Credits). Minor Awards are awards of between 10-50 Credits. If a programme does not run, whether Major or Minor, a full refund is offered.

Applicant Confirmation of Identity

Once successful in your application, you will be contacted by the Faculty of Lifelong Learning to confirm dates for registering. Please note that during registration photographic identification is required, for example, Passport / Driving Licence / Public Services Card.

Additionally, a copy of your Birth Certificate and Marriage Certificate (where applicable), to confirm the official name to appear on your student card and subsequent parchment on completion of your studies.

Applicant Declaration

Applicant Declaration

I declare that the information given by me in this application is true and accurate and that if accepted I agree to read and abide by the regulations of Institute of Technology Carlow.

I hereby agree that the Institute may use my photograph in publications of the Institute where they judge this to be in the best interest of either myself or the Institute.

I understand that the Institute of Technology Carlow will treat all information as confidential and will not disclose such information except as permitted by Law.


The Institute of Technology Carlow is committed to protecting the rights and privacy of individuals with respect to the processing of their personal data. A copy of the Institute’s Privacy notice is available on the Institute’s website ( This website also contains further information relating to your rights regarding subject access requests, records retention and data protection in general. Any further queries in relation to the GDPR can be addressed to the Institute’s Data Protection Oversight Group (e-mail: