Writers in Residence Republic of Ireland: Application Form

Writers in Residence Republic of Ireland: Application Form
Name Of School*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Roll Number
School's Phone Number

Area CodePhone Number
School's email*
Teacher

First NameLast Name
Contact Email
Mobile Number

Area CodePhone Number
Proposed Writer
Class
Number Of Students
Number Of Sessions
Start Date*

MonthDayYear
End Date*

MonthDayYear
Focus of Project*
It would be useful if you could outline, as appropriate, any requirements such as special needs, ESL/EAL students, specific cultural sensitivities, recent bereavements or traumatic events
Should the teacher be absent from the classroom for any reason during the writer’s visit, responsibility for any incident which may occur during his/her absence rests entirely with the school, and the school further agrees to indemnify the writer and/or Poetry Ireland Writers in Schools without limitation in respect of same.

Please read our financial terms and conditions
I have read, understand and agree to the above condition and financial terms*

Yes
Writers in Schools, Poetry Ireland, 11 Parnell Square East, Dublin 1

Phone: +353 1 678 9001 Email: education@poetryireland.ie
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