Supplementary Information Form

The Supplementary Information Form has two purposes:
  • To inform Higher Education Institutions of specific supports you may need in relation to your disability/specific learning difficulty.
  • To allow you to be considered for DARE and other supplementary admissions routes for students with disabilities/specific learning difficulties.
    DARE scheme information           DARE and Non-DARE Institution List
Please complete the following form and click on the 'Submit' button when you have finished.
Note: If this form is taking too much time to complete, you may save your details and continue on to complete the form.

Closing Dates:
17:15 on 1 March 2018 - Complete Section A and answer Yes/No to Question 1 on this form.
17:15 on 1 April 2018 - Submit Section B and Section C forms (or other evidence of disability documentation) by post.

Supplementary Admissions Routes

Q.1
Do you wish to be considered for DARE?
To be eligible for DARE, your disability must have had a negative impact on your second level education. For further information on DARE Eligibility Criteria please see accesscollege.ie


Section A - Applicant Information

Q.2
Please indicate your primary disability/specific learning difficulty:


Q.3
Do you have any other disabilities/specific learning difficulties?

Q.4
Please list the supports you received in 2nd level. Please also list the supports you may require in 3rd level.
Support Type Supports actually received at second level Supports required at third level 
Accessible Accommodation
Alternative Print Format
Assistive Technology
Campus Orientation
Counselling
Dyslexia Support
Examination Support
Learning Support
Note-taker
Personal Assistant
Sign Language Interpreter
Transport
Wheelchair Access
Other(s), please specify below:

Q.5
The Personal Statement outlines, from your point of view, the impact of your disability or specific learning difficulty on your education.

This is an opportunity for you to tell us about your experience of being in school and the challenges you faced. These challenges might include (but are not restricted to) your exam results and learning, attendance, overall experience and participation in school, memory or concentration issues, meeting deadlines, access to texts/materials and any other educational impact of your disability. You may use bullet points.

 
You may enter up to 1500 characters. Characters left:

Section B - Educational Impact Statement

The Educational Impact Statement (EIS) is used along with evidence of disability documentation to help determine your eligibility for DARE. The form also provides background information to colleges on your educational experience and helps to determine appropriate supports at third level.
The appropriate teacher in the school should complete the EIS checklist with you. Your response to each of these questions should act as a guide for the teacher in deciding what information they may need to gather to complete the rest of the EIS. The person completing this form should be familiar with the impact of your disability on your academic performance and participation at second level.

You must have a PDF viewer installed on your computer before you can use a PDF form. Click here to download Adobe.
The form can be completed by your school on a PC/Laptop and then printed or it can be printed off and handwritten. Click here for helpOpens in a new window

Educational Impact Statement:   Download  

Section C - Evidence of a Disability

The Evidence of Disability Form is used along with evidence of educational impact to help determine your eligibility for DARE. The form is also used by HEIs to provide verification of your disability and helps to determine appropriate supports at third level. All applicants must complete this form with the exception of the following:

If you have an existing diagnosis but have difficulty accessing the appropriate professional to get confirmation of the existing diagnosis or an updated report, you may ask your general practitioner (GP) to complete the Section C Evidence of Disability form. They must however have the required information on file from the appropriate professional and within the given time limit, if one applies. A copy of the document in which your diagnosis is confirmed must be included in your application when using this GP verification. (More Information)

Diagnoses made by GPs alone will not be acceptable. Evidence from a Support organisation will not be accepted as verification of a disability.

Please provide evidence for all disabilities/ medical conditions which you have disclosed.

Evidence of a Disability Form:   Download  

It is your responsibility to ensure that all sections of the Evidence of a Disability form are completed. Remember to keep a photocopy for your personal records.



Declaration: