BLAS SUMMER SCHOOL &

SCOIL SAMHRAIDH WILLIE CLANCY

APPLICATION FORM

Section 1: Personal Information

First Name: ______Surname: ______

Address for correspondence: ______

______

______

Country: ______

Phone: ______Mobile: ______

Email: ______

D.O.B: ______Sex: Male £ or Female £

Note: If you are a member of a group booking please indicate the name of the group or group leader here: ______

Blas Focus Area 1:

(Instrument/song/dance class sought and level of competency in this area)

Flute £ Fiddle £ Percussion £ Song £

Harmonic Accompaniment £ (State what instrument: ______)

Dance £ (State what style: ______)

Other* £ (Please state: ______)

*Note: Tuition in other instruments can be provided, depending on the level of interest

Level of Competency in Area 1:

(NB: Blas CANNOT cater for complete beginners on an instrument new to them other than on bodhrán in the percussion classes.)

Beginner/Intermediate £ Intermediate/Advanced £

Blas Focus Area 2:

You may wish to include a second focus area (second instrument/song/dance class):

Focus Area 2: (as from above) ______

Level of Competency: ______

Level of Irish for Blas Irish Class:

Beginner £ Intermediate/Advanced £

Section 2: Tuition Fees
BLAS
Monday July 2nd—Friday July 6th / ·  All masterclasses, workshops, ensemble classes, and style & repertoire classes
·  All lunchtime and evening concerts
·  All lectures and Irish language classes
·  All evening events, including sessions on campus lead by guest musicians, Trad table quiz, céilithe, etc.
SCOPE OF IRISH TRADITIONAL MUSIC
Saturday July 7th—Sunday July 15th / ·  Access to all classes, workshops (morning), lectures (afternoons), and evening recitals
·  Admission to Eire’s Alba Concert on Sunday July 8th, 2018
·  Admission to all afternoon events at the Marquee (details TBC)
·  Admission to Irish and Scottish Gaelic conversational language classes
·  Students are entitled to reduced admission to all céilithe
·  Note: This fee does not include admission to the concert Saturday July 14th, 2018
TOTAL COST: /

€520

Section 3: Accreditation

This initiative betweenBlasand Scoil Samhraidh Willie Clancy will enable students to earn university accreditation worth 3 undergraduate credits (6 ECTS credits). Students wishing to pursue accreditation will be required to complete both the second week ofBlasandThe Scope of Irish Traditional Music.
Students must undertake the tuition given and attend lectures and extra curricula events in excess of 50 contact hours. The student also sits a written examination or assignment at the end of the initiative.
While the University of Limerick provides accreditation to the successful student, Blas and Scoil Samhraidh Willie Clancy cannot guarantee that this accreditation will be recognised by your home institution. The onus is on the individual to request and confirm that this accreditation is recognised by the relevant institution at which they study full time. / Tick below to confirm you wish to undertake the accreditation process:
□

Section 4: Blas Accommodation and Meal Packages

Note: The following applies to accommodation and meal packages for Blas Summer School only. For accommodation during Scoil Samhraidh Willie Clancy, please contact Maureen Kilduff by phone (065-7085107) or email ()
*Blas Accommodation Packages do not include the cost of tuition (see Section 2 for tuition fees). Lunch is not included under any meal package. / Tick the option below if you wish to book an accommodation package:
One Week Package
Monday July 2nd—Friday July 6th / ·  5 nights accommodation, Sunday July 1st through Thursday July 5th inclusive.
·  Continental breakfast delivered to your apartment each morning (Monday July 2nd to Friday July 6th inclusive).
·  Evening meal served on campus the evenings of Monday July 2nd to Thursday July 5th inclusive. /

€400 □

Extra Night Accommodation / ·  Should an extra night of accommodation be required on either end, this will be charged at €60 per night on a bed and breakfast basis only.
·  Please tick from the options listed on the right if needed /
Sat June 30th
€60 □
Fri July 6th

€60 □

PAYMENT SUMMARY

Please fill out the information below with reference to your payment:

DATE/S / PAYMENT FOR / INFO / FEE/
EURO
July 2018 / Tuition Fee / €520
July 2018 / Blas Accommodation Fee / €
July 2018 / Blas Extra Night Fee / Date of extra night(s): / €
July 2018 / Minus 10% Early bird discount (- €52) / Students enrolled before
March 17th, 2017—applicable to tuition fees only. / €
TOTAL DUE / €
STUDENT NAME / TOTAL AMOUNT BEING PAID
€

PAYMENT DETAILS

Please pick from one of the following payment options:

METHOD OF PAYMENT / INFORMATION OF PAYMENT / TICK OPTION
OPTION 1
Cheque/Bank Draft / If paying by eurocheque or bank draft please ensure that it is made payable in Euro to:
UNIVERSITY OF LIMERICK
(*It is essential that ‘University of Limerick’ be included here, not Blas Summer School) /
OPTION 2
Wire Transfer / In order to make the payment, you must include:
·  Student name
·  Summer school name: ‘Blas Summer School’
·  Blas Cost Code: 60073
The payment is then made to the following bank account:
Bank Name: Bank of Ireland
Bank Address: Bank of Ireland, 125 O’Connell St., Limerick
Bank Swift Code: BOFIIE2D
Bank Sort Code: 904309
Account Name: University of Limerick No 1 Current Account
Account Number: 10672775
IBAN Number: IE02 BOFI 9043 0910 6727 75 /

Signature & date*:

SIGNATURE:
DATE:

*Signature must be of valid cardholders/fund account and that of parent/guardian of students under 18.

MUSIC/DANCE EXPERIENCE

Please use this section to give a brief explanation of your music or dance experience to date.

HOW DID YOU HEAR ABOUT THE BLAS/SSWC INITIATIVE?

Please help us by giving as much detail as possible below:

£ Online (website, e-newsletter, etc.): ______

£ Social Media (Facebook or Twitter): ______

£ Printed Publication (e.g. magazine, program, newspaper, etc.): ______

£ Friend

£ Other: ______