UCD School of Information and Library Studies
Application for Auditing Modules 2011/12
Personal Details
Surname
Title (Dr/Mr/Mrs/Miss/Ms)
First Name(s)
Permanent “Correspondence” Address:
Phone (day-time): ______________
Phone (evening):
______________
E-mail:_______________________
Home Address (if different from above)
Phone: ______________________
Country of Permanent Domicile
i.e. taxation status (for fee purposes only)
University Education : completed
University
Dates
Degree
Date of Birth
Subject(s)
Recent Employment
Employer
Position
Responsibilities
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Class of Honours
Dates
UCD School of Information and Library Studies
Application for Auditing Modules 2011/12
Relevant Competencies and Awards
E.g., Involvement in professional groups; Prizes or scholarships; Honours or distinctions;
Volunteer work
If you have been a UCD student before, please give your student number here:
Student Number:____________________________
Applicant's Signature:______________________________________
Date:
Number and name of modules you wish to audit (Semester 2, Jan. 2011):

IS _______________________________________________

IS _______________________________________________

IS _______________________________________________
Cost per module for the semester beginning 16 Jan. 2012 is €190.
Please complete and return this application form along with your
payment in full to:
The School Administrator
UCD School of Information and Library Studies (SILS)
Belfield, Dublin 4, Ireland.
Phone: (01) 7167055
Fax:
(01) 7161161
Email: sils@ucd.ie
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