ApplicationFormHDipLSMD

Page 1

THE LEINSTER SCHOOL OF MUSIC & DRAMA

COURSES IN GCD & GCC

How to find us:

SECTION ONE - PERSONAL DETAILS

Higher Diploma in Arts in Music Education HETAC Level 8

PLEASE USE BLOCK CAPITALS ADDRESS

SURNAME

EMAIL

TEL. (WORK)

Certificate in Music Teaching 40 credits – HETAC

TEL. (HOME)

DOB

(Licentiate of The Leinster School of Music & Drama)

(MOBILE)

MALE

FIRST NAME

� FEMALE

Certificate in Music Teaching 20 credits – HETAC

SECTION TWO - COURSE CHOICE

(Associate of The Leinster School of Music & Drama)

COURSE TITLE COMMENCEMENT DATE

LOCATION

Cork

AVAILABILITY

Day

MODE OF DELIVERY (Higher Diploma only) �

Part-time

Courses can be paid for by giro, cheque, bank draft or credit card. Griffith College discourages the payment of fees by Evening � cash. Please tick the method of your choice and complete Full-time the rest of the details as appropriate. Dublin

PLEASE INDICATE HOW YOU FIRST BECAME AWARE OF THE LEINSTER SCHOOL OF MUSIC & DRAMA PROGRAMMES Radio �

Newspaper

Friends/Family

Work

Internet

DUBLIN

CORK

Griffith College Cork, Cove street, Sullivan’s Quay, Cork Phone: (021) 450 7027

The Leinster School of Music & Drama Griffith College Campus South Circular Road, Dublin 8 Phone: (01) 415 0466 / 7

THE LEINSTER SCHOOL OF MUSIC & DRAMA

Other �

PAYMENT METHOD Cheque, Postal Order or Bankers Draft

Credit Card (Access/Visa/Mastercard) ADDRESS

CARD HOLDER’S NAME

CARD NO

PLEASE DEBIT MY CARD

E

CARD HOLDER’S SIGNATURE

CERTIFICATION

TITLE OF DEGREE

MUSIC PERFORMANCE GRADE

EXAM BOARD

DATE AWARDED

EXAM BOARD

DATE AWARDED

I certify that the information given above is correct and I hereby undertake to comply with all regulations of The Leinster School of Music & Drama. I also accept that the LSMD reserves the right to change any of the details given in any course brochure and that the course commencement is dependent on student demand. The course fee will not be refunded once the course has started.

SIGNATURE

Griffith College Campus South Circular Road Dublin 8

DATE AWARDED

AWARDING BODY

GRIFFITH COLLEGE

Applicants should complete the application form (available over) indicating their chosen programme, mode and location of delivery and forward to:

The Leinster School of Music & Drama

Postgraduates must supply an original certified copy of final exam results. Original copies of certification for music performance and theory examinations must be supplied.

MUSIC THEORY GRADE

A CONSTITUENT SCHOOL OF

HOW TO APPLY:

EXPIRY DATE:

Phone: Dublin (01) 415 0466 / 7 Phone: Cork (021) 450 7027 Email:

leinster.school@gcd.ie

Website: www.gcd.ie/lsmd

DATE

ESTABLISHED 1904

DUBLIN • CORK

ESTABLISHED 1904


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ApplicationFormHDipLSMD by Griffith College - Issuu