Parent Name (required)

Child 1 Age (required)

Child 2 Age (If any. Optional)

Your Email (required)

Contact Number (required)

Course (Select all courses interested)

STARTER - Age 5+ to 7 - Block Based CodingEXPLORER - Age 7+ to 9 - Block based Scratch, Websites, Mobile AppsDeveloper - Age 9+ - Block based Games, Roblox & Minecraft Games CodingProfessional - Age 11+Summer Camps(In Person) - Age 7-10

Preferred DUBLIN Community Centre Locations (Select all convenient centres)

AdamstownBalbrigganDunboyneLeixlipLucanMalahideStillorganSwordsDublin 1-4Dublin 5-Donnycarney CCDublin 6 & 14 -Taney Parish CentreDublin 8-St Andrews CCDublin 12-Drimnagh CCDublin 13-Baldoyle CCDublin 14-Taney Parish CentreDublin 15-Ongar CCDublin 15-Diswellstown CCDublin 16 - Knocklyon CC(Near Dundrum)Dublin 18-Sandyford CCDublin 22-Rowlagh CCDublin 24-Rathcoole CCDublin 24-Firhouse CCDublin 24-Dominic's CC

Preferred CORK Community Centre Locations (Select all convenient centres)

Cork - Ballyphehane Community CentreCork - BallinCollig - The Carraig CentreCork - Blackpool Community CenterCork - Carrigaline Community ComplexCork - Cobh - Great Island Community CentreCork - Douglas Community CentreCork - Glen Resources CentreCork - Glounthaune Community CenterCork - Ringaskiddy Community CentreCork - Riverstick Community CenterCork - SMA Wilton Parish CentreCork - The Rock Community Centre

Preferred GALWAY Community Centre Locations (Select all convenient centres)

Galway - Ballinderreen Community CentreGalway - Ballinfoile Castlegar Neighbourhood CentreGalway - Killannin Community CentreGalway - Knocknacarra Community CentreGalway - Renmore Community CentreGalway - St Joseph's Community CentreGalway - Oranmore community centreGalway - Westside Resource Centre

Preferred WEXFORD Community Centre Locations (Select all convenient centres)

Barntown Community CentreBree Community CentreClonard Community CentreKnockingall Community CentreMurrintown Community CentreOylgate Community CentreRosslare Community & Sports CentreSt Joseph's Community CentreTempleshannon Community Centre

Other Locations Preferred (Other than Zone listed above. Optional)

Preferred Day & Time (required. Select all convenient time)

Monday (5PM - 7PM)Tuesday (5PM - 7PM)Wednesday (5PM - 7PM)Thursday (5PM - 7PM)Friday (5PM - 7PM)

Any Special Needs like Dyslexia/Autism/ADHD or anything other?(required)

YesNo

Your Query (If any)