Parent Name (required)

Child 1 Age (required)

Child 2 Age (If any. Optional)

Your Email (required)

Contact Number (required)

Course (required. Select all courses interested)

STARTER - Age 5+ to 7 - Block Based CodingEXPLORER - Age 7+ to 9 - Block based Scratch, Websites, Mobile AppsGAMER - Age 9+ - Block based Games, Roblox & Minecraft Games CodingDeveloper - Age 11+

Preferred CORK Community Centre Location (required. Select all convenient centres)

Ballyphehane Community CentreBallinCollig - The Carraig CentreBlackpool Community CenterCarrigaline Community ComplexCobh - Great Island Community CentreDouglas Community CentreGlen Resources CentreGlounthaune Community CenterRingaskiddy Community CentreRiverstick Community CenterSMA Wilton Parish CentreThe Rock Community Centre

Preferred GALWAY Community Centre Location (required. Select all convenient centres)

Ballinderreen Community CentreBallinfoile Castlegar Neighbourhood CentreKillannin Community CentreKnocknacarra Community CentreRenmore Community CentreSt Joseph's Community CentreOranmore community centreWestside Resource Centre

Preferred WEXFORD Community Centre Location (required. 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)