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.
To allow you to be considered for DARE and other supplementary admissions routes for students with disabilities.
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:
17:00 on 1 March 2023 - Complete Section A and answer Yes/No to Question 1 on this form.
17:00 on 15 March 2023 - Submit Section B and Section C forms and where relevant Section D (or other evidence of disability documentation) by post.

Supplementary Admissions Routes

Q.1

Do you wish to be considered for DARE?

Yes

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

By ticking yes, I confirm that I have read and I accept the terms and conditions as outlined below. I consent to the use of my data as detailed in the terms and conditions.

By 17:00 on 1 March 2023
You must complete Section A of the Supplementary Information Form and indicate your wish to be considered for DARE.

By 17:00 on 15 March 2023
You must submit the Educational Impact Statement (Section B) and the Evidence of Disability (Section C and/or Psychology report or existing report) and where relevant Section D to:

DARE Applications 2023,
CAO,
Tower House,
Eglinton St.,
Galway.

Verification should be provided for all disabilities you have disclosed.

Q.1(b) If you applied to CAO in 2022 and you were deemed eligible for DARE in 2022 please enter your 2022 CAO application number in this box. Click here for help

By carrying forward your DARE 2022 eligibility, you are agreeing to share your DARE 2022 application information with the DARE participating colleges that you may apply to, for entry 2023.

CAO 2022 Application Number:

Terms and Conditions:

I have read, understood and will comply with the rules and requirements of application as detailed in the DARE Application Handbook.
I understand that it is my responsibility (and not that of my parents, guardians, teachers, or anyone else) to ensure that all parts of my DARE application are submitted in a complete and accurate manner, within the DARE deadlines. Failure to do so will negatively affect the outcome of my DARE application.
I understand that:
1. information provided on my DARE application form by 1 March 2023,
2. documentation received by the CAO by 15 March 2023 and, where relevant,
3. any further additional documentation requested by DARE received within the specified deadline,
4. and any further information considered relevant by DARE,
will be considered when determining the outcome of my DARE application.
Neither the CAO nor the participating DARE higher education institutions will accept any responsibility for any loss or hardship arising as a result of an applicant's failure to supply correct and complete information at the appropriate time.
I understand that all information supplied as part of my DARE application may be subject to verification or clarification and that DARE can request additional documentation from me in relation to any aspect of my application. Failure to supply additional documentation within the specified deadlines will result in my ineligibility for DARE.
I understand that DARE can request that I attend for assessment by an independent professional (or where required, by a number of independent professionals), to be nominated by DARE as part of DARE's consideration of my application, and that:
1. DARE will cover the cost of this assessment and any reasonable costs that I may incur in attending. The determination of such reasonable costs will rest with DARE.
2. Failure to attend testing within the specified deadlines will result in my ineligibility for DARE.
I understand that, if I accept a DARE place, a condition of acceptance is that I must register with the Disability Service of the participating higher education institution which I am admitted to, and agree on a schedule of meetings with that service. I accept that failure to register or attend scheduled meetings with the Disability Service without prior permission from the service, could result in my reduced points DARE place being withdrawn.
Where I am found to have made false declarations, or it is found that anyone else has made false declarations as part of my DARE application, I understand that I will be ineligible for DARE. I also understand that the participating DARE higher education institutions reserve the right not to consider my application, and/or to cancel any offers of places in cases where it is found, during or post-admission to higher education, that false or misleading information was supplied in my DARE application.
I understand that data contained in my DARE application will be used for research and analysis purposes by participating HEIs, agents acting on behalf of the HEIs or the CAO, but that this data will be anonymised and none of my personal data will be identifiable should it be published.
I certify that all information I have supplied in my DARE application is accurate and true.

(Click to save your details and continue on to complete the form.)

Section A - Applicant Information

*Important note for applicants with Dyslexia/ Significant Literacy Difficulties or Dyscalculia/ Significant Numeracy Difficulties

A full Psychological Assessment Report OR Section D School Statement must be submitted for applicants with Dyslexia/ Significant Literacy Difficulties. In addition, applicants with Dyslexia/ Significant Literacy Difficulties must also have two literacy attainment scores at or below the 10th percentile (Standard Score of 81 or below) from testing carried out on or after 1 February 2021.

A full Psychological Assessment Report must be submitted for applicants with Dyscalculia/ Significant Numeracy Difficulties. In addition, applicants with Dyscalculia/ Significant Numeracy Difficulties must have one numeracy attainment score at or below the 10th percentile(Standard Score of 81 or below) dated after 1 February 2021.

Q.3

Do you have any other disabilities?

Yes

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	Yes No	Yes No
Alternative Print Format	Yes No	Yes No
Assistive Technology	Yes No	Yes No
Campus Orientation	Yes No	Yes No
Counselling	Yes No	Yes No
Dyslexia Support	Yes No	Yes No
Examination Support	Yes No	Yes No
Learning Support	Yes No	Yes No
Note-taker	Yes No	Yes No
Personal Assistant	Yes No	Yes No
Sign Language Interpreter	Yes No	Yes No
Transport	Yes No	Yes No
Wheelchair Access	Yes No	Yes No
Other(s), please specify below:
	Yes No	Yes No
	Yes No	Yes No
	Yes No	Yes No

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Q.5

The Personal Statement outlines, from your point of view, the impact of your disability 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:

(Click to save your details and continue on to complete the form.)

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 help

Educational Impact Statement: Download

Section C - Evidence of 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:

Applicants with Dyslexia / Significant Literacy Difficulties or Dyscalculia / Significant Numeracy Difficulties are asked to provide a full Psychological Assessment Report completed by an appropriately qualified psychologist instead of the Section C Evidence of Disability Form. This report must be signed by the psychologist and submitted on the psychologist's headed paper/accompanied by their business card/stamp. Failure to do this may result in an applicant being ineligible for DARE. You should go to accesscollege.ie for guidelines. Where the applicant is applying under the Dyslexia / Significant Literacy Difficulties category, but does not have a full Psychological Assessment Report, they should instead download Section D (School Statement), request the school to complete this statement and return it to the CAO to arrive by 5pm on March 15, 2023. The psychological report/Section D must be accompanied by attainment scores from tests administered by your school and/or an appropriately qualified psychologist.
Applicants who have an existing report completed by the accepted Medical Consultant/Specialist: This form must be completed by the accepted consultant/specialist. The report must contain the same detail as the Evidence of Disability. The form must be signed by the consultant/specialist and submitted on their headed paper/accompanied by their business card/stamp.
Applicants who are Deaf/Hard of hearing have a number of options to provide evidence of their disability. Please see the Evidence of Disability Form for further detail.

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 Disability Form: Download

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

Section D

Where the applicant is applying under the Dyslexia / Significant Literacy Difficulties category, but does not have a full Psychological Assessment Report, they should instead download Section D (School Statement), request the school to complete this statement and return it to the CAO to arrive by 5pm on March 15, 2023.

The psychological report/Section D must be accompanied by attainment scores from tests administered by your school and/or an appropriately qualified psychologist.

Download Section D: Download

Declaration:

I certify that the information given above is correct and I hereby undertake to observe and comply with the regulations of the CAO.

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