You may request that application instructions and an application form for Fall 2008 entry to the Irish medical schools be sent to you via email by completing and submitting the Application Request provided below.

Note: The application form and instructions you receive from us will correspond directly with the information you provide here. If you provide incomplete or inaccurate details, you may not receive the correct information. We will not respond to incomplete or partially completed Application Requests.

Contact Information

First Name:
Last Name:
Country of legal residence:
Citizenship:
Mailing address:
City:
State / Province:
Zip / Post Code:
E-mail address:
Phone number:	( ) -

Desired Medical School Admission Year

Enter the year in which you wish to commence medical studies in Ireland:

Desired Medical School(s)

Enter below the name(s) of the school(s) to which you wish to apply:

Academic Background

Please provide below specific details of your academic background to date. Be sure to include: The dates upon which you graduated/will graduate from high school, college or university. The type(s) of degree(s) you are studying towards or have been awarded. The name(s) of the school(s) you have attended or are currently attending.

Standardized Examinations

If you have written any of the following examinations enter YES in the appropriate box. If you plan to write any of them for the first time in the future, enter that future date. If you leave a blank, we will presume that you have not written it and will not be writing it.
ACT:		SAT I:
SAT II:		MCAT:
AP:
Subjects:
IB:
Subjects*:
*For IB subjects, indicate whether Higher (H) or Standard (S) level.

Press Submit

When the form is complete, press the Submit button below.