Declaration of Interest Form
Email address *
Applicant Data Protection Acknowledgment
By submitting my expression of interest in this form to attend the course(s), I acknowledge that the data controllers may process my personal details for the purposes of assessing my eligibility for the course and to contaect me with the follow-up correspondence. I understand that I may also address any questions, comments and/or access requests regarding my personal details to dataprotection@ddletb.ie
First Name *
Last Name *
Address 1 *
Address 2 *
Address 3 *
Address 4
Mobile Phone No *
Landline No
Gender *
What is your highest level of education?
Have you attended Fingal Adult Education Service before? *
Do you have a medical card? *
Are you in receipt of a social welfare payment from the Department of Social Protection? *
Are you over 18 years of age? *
Are you over 21 years of age? *
If English is not your first language, please state your English language proficiency: *
Course of Interest *
Required
A copy of your responses will be emailed to the address you provided.
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