Player Portfolio: BA Sport and Exercise (GAA) CW807

This form is only to be completed by applicants for the above

programme

Name: ____________________________

Playing position: _________________

Please follow the instructions below carefully when completing the portfolio:

- Youmustcompleteallsectionsoftheform.AnysectionthatisnotapplicabletoyoupleasefillinN/A.Pleasecompleteinblockcapitalsandinblackink.

- Makesuretoattachacurrentpassportphotographofyourselftotheform.- Ifyouhaveanyofthefollowingattachacopybystaplingtotheform(pleasedo

notsubmitoriginalsofanyqualifications,thesewillnotbereturned)o FetacAwardresultsorequivalento CollegeorUniversityresults.

- Youmustgivefullcontactdetailsofallrefereesgiven.- MakesuretoreadandsigntheApplicantDeclaration.- PleasenoteallsuccessfulapplicantsarerequiredtohaveGardaVettingclearance

priortofullregistration.Thiswillbeinitiatedduringprogrammeinduction.- Theportfolioformmustbereturnedtoprogresstheapplicationprocess.- ThecompletedformMUSTbefullycompletedandreturnedto:

DepartmentofSportMediaandMarketing,ITCarlow,KilkennyRd,Carlow.

Attach passport photo securely here

Section A Personal Details

Personal Details: Surname: _______________________________________________ First Name: ______________________________________________ Home address: ______________________________________________ _______________________________________________________________ _______________________________________________________________ Date of Birth: _______________ County of Birth: ________________ Male: Female: Email: _______________________ Tel. No: ___________________ Mobile no: _____________________ You must include both of the following numbers. PPS No: CAO No

Section B Education Details If you are not doing the Leaving Certificate examination in the current year, please state the year you completed the Leaving Certificate: ___________________ List your leaving certificate subjects in the section below clearly and accurately. Include the grade achieved if you have already completed your leaving certificate. H = Honours O = Ordinary F = Foundation

School: _______________________________________________________

Post Leaving Cert and Third Level Education:

List all FAS, PLC (i.e. FETAC) and 3rd level education courses you have completed or are currently

completing.

College Attended

Course(s) Taken Date (From/To)

Result

SECTION C GAA

Sports Played (tick all that apply) Football Hurling Camogie Handball Other (list)______

GAA PLAYING HISTORY Underage – (U12s – U18s)

School involvement

Name of School

Highest Grade played

(Senior, Junior, Juvenile)

Competition

Grade (A,B,C, or D)

Playing Position

Approximate

number of games played

Year

Club involvement

Name of Club

Highest Grade played

(U14, U16, U18)

Competition

Grade (A,B,C, or D)

Playing Position

Approximate

number of games played

Year

Highest level of Underage County up to and including Minor:

Name of Team/ Squad Manager Approximate number of

games played

Year

GAA PLAYING HISTORY ADULT

Club Playing History

Name of Club ____________________________________

Grade played (U21, Junior,

Intermediate, Senior)

Playing Position

Approximate

number of games played

Year

Adult County:

County ____________________________________

Grade played (U21, Junior, Intermediate,

Senior)

Manager Playing Position Approximate number of games played

Year

NOW MOVE TO SECTION D COACHING

SECTION D COACHING

COACHING QUALIFICATIONS

List all coaching qualifications you have completed. Complete all sections.

Coaching Award/ Coaching Badge

Governing Body/ Awarding Body

Venue of Course Date Completed

e.g. Awards 1 GAA IT Carlow Oct 2013

Other sport and coaching related qualifications:

List other sport and coaching related qualifications you have completed, e.g. First Aid,

Referees, Club Development etc. Complete all sections.

Coaching Award/ Coaching Badge

Governing Body/ Awarding Body

Venue of Course Date Completed

e.g. Basic 1st Aid Order of Malta IT Carlow Nov 2014

COACHING EXPERIENCE

List any coaching and managerial positions you have held. Include all positions you

have held both voluntary and paid positions.

Name of Club/ Organisation (include age group and your

role)

From

Until

Name and number of contact at that club/

organisation e.g. IT Carlow Boys U12 Hurling B team (Asst Coach)

Aug 2014

May 2010

Ms. Marie Moore 087-11223344

SECTION E OTHER INFORMATION

CAREER GOALS AND ACADEMIC INTERESTS

1. Outline your long term career goals and how you think a place on the course will

help you achieve these goals.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

2. What academic interests do you have and what course areas would you like to

pursue if you are successful in your application.

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

3. What do you believe to be your strengths and weaknesses as an individual?

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

SECTION F REFERENCES

REFERENCES

Give contact details of referees below. You should provide two references both in

relation to your sporting background / career.

Referee 1.

Forename: __________________ Surname: __________________________

Role: ______________________________________________________________

Current Postal Address:

______________________________________________________________________

________________________________________________________________

Ph: __________________________ Mob: ______________________________

Referee 2.

Forename: __________________ Surname: __________________________

Role: ______________________________________________________________

Current Postal Address:

______________________________________________________________________

______________________________________________________________________

_____________________________________________________________

Ph: __________________________ Mob: _____________________________

SECTION G APPLICANT DECLARATION

APPLICANT DECLARATION

I certify that the information provided in this application is complete and true to the best

of my knowledge. I agree to be bound by the regulations of IT Carlow and the GAA.

Applicant Signature: ______________________________________________

Date: ______________________________________________

Consent for digital recording of skills assessment element of the portfolio

application

As part of the skill assessment element of the portfolio application, it may be necessary to digitally record the session. For this, consent is required from you or (your parent/ guardian if under 18 years). Please sign below as an indication of your consent.

Applicant Signature: ______________________________________________

Parent/Guardian Signature (if applicant is under 18) __________________________

Date: ______________________________________________