Language Waiver Application Form

To be considered for a language waiver on disability grounds, please complete the application form below and email all required supporting documentation to LanguageWaiver@mic.ul.ie before 1 July.

Supporting documentation required to accompany your application:

MIC Language Waiver Declaration form completed and signed by your School Principal
Copy of your Certificate of Exemption issued by the Department of Education signed and stamped by your school principal
Or
Copy of Educational Psychologist Report

Please note: All supporting documentation needs to be returned to the above email address no later than 1 July for applications to be processed.

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Please complete all sections:

Name

Surname

Address

Phone

Confirm email

Date of Birth

CAO Number

At Post Primary School did you study Irish and or another foreign language?

Please provide details of the most recent examination you have taken in that language.

I have been diagnosed as having a specific learning difficulty or significant sensory impairment affecting language skills.

Signature

Date

Data Protection

Personal information collected by MIC is treated with the highest standards of security and confidentiality in accordance with the General Data Protection Regulations (GDPR). Data collected will be retained in line with MIC’s Records Retention Schedule.

I consent that personal information and supporting documentation supplied by me in this application will be used by MIC to assess my eligibilty for a Language Waiver on Disability Grounds. Information for this application will be processed by the Access & Disability Office. I agree to this data being kept as part of the permanent record and being archived. I understand that I have a right to withdraw my consent at any time by emailing LanguageWaiver@mic.ul.ie. Your privacy is important to us. For further information and full data privacy notice please click here.

By completing this form, you are requesting that your information is processed in line with College procedures. Please read the MIC Student Data Privacy Notice for more information on your rights and how MIC processes your data. Any queries or concerns in relation to the processing of your personal data by the College should be addressed to MIC's Data Protection Officer at DataProtection@mic.ul.ie.

Please tick this box to confirm that you have read and accept the information above.