Gaelcholáiste Mhuire (AG), An Mhainistir Thuaidh, Corcaigh.
The Lehane Scholarship 2018
      Application Form 
These particulars will be regarded as STRICTLY CONFIDENTIAL
1. Applicant
Name:_______________________
Home Address:_________________________________________
Telephone/Mob No: 
Date of Birth:_______   
CAO Code and Title of Honours Bachelor Degree - Level 8 - Course accepted: _____________________________________________________________
Have you been accepted on the HEAR and/or DARE schemes?

Have you received the SUSI grant?

2. Applicant's Father/Guardian:
Name:_________________________
Occupation:______________________

3. Applicant's Mother/Guardian:
Name:	
Occupation: ____________________________
4. Gross Combined Income per year: Tick appropriate box:

Less than € 20,000  €20,000->€ 30,000  €30,000 -> € 40,000 More than € 40,000

P.T.O ->