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Intensive Interaction - Application Form
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Email
*
Your email
NCSE SUPPORT SERVICE - CONTINUING PROFESSIONAL DEVELOPMENT
Venue and Date of Seminar
Please select the Venue and Date you wish to attend from the dropdown menu below
*
Choose
March 23, 2020 : Monaghan Education Centre
March 24, 2020 : Mayo Education Centre
March 26, 2020 : Limerick Education Centre
March 27, 2020 : Dublin West Education Centre
Teacher Information
Teacher First Name
*
Your answer
Teacher Surname
*
Your answer
Teacher Payroll Number (DES)
*
Your answer
Teaching Council Number
*
Your answer
Mobile No.
*
Your answer
E-mail Address to which confirmation will be sent
*
Your answer
School Information
Type of School
*
Primary
Primary DEIS Urban Band 1
Primary DEIS Urban Band 2
Primary DEIS Rural
Post Primary
Post Primary DEIS
Special School
Required
School Name
*
Your answer
School County
*
Your answer
School Roll Number
*
Your answer
Indicate the Role(s) you have in the School
*
Principal/Deputy Principal
Class Teacher
Special Class Teacher
Special Education Teacher
SEN Co-ordinator
Required
Please confirm the number of students with Autism you are currently teaching
*
Your answer
Please tick here to confirm that you have permission from your Principal to attend this course
*
Yes
Required
Please Note
• Return of this application form does not guarantee a place on this course
• Applicants who are allocated a place will receive confirmation to the email address provided
• All requested details must be provided for the application to be processed.
Additional Requirements for the Course
Please contact the office below if you have any special accessibility or other requirements for the course
GDPR
Full details of the NCSE’s data protection policy setting out how we will use your personal data as well as information regarding your rights as a data subject are available at
http://ncse.ie/ncse-data-protection
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https://policies.google.com/privacy
Contact Information
National Council for Special Education
(Teacher CPD)
1-2 Mill Street
Trim
County Meath
Tel: 01-6033200
A copy of your responses will be emailed to the address you provided.
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