New Client Form

Please fill out form as best you can. Mandatory fields are marked with an asterisk (*)

First name *

Last name

Year of Birth *

Address *

Email / Parental Email *

Emergency Contact Name *

Emergency Contact Phone *

Why did you contact Career Insights? *

What would you like to get from working with Career Insights? *

Please identify how career guidance in school has helped you. *

If you have had career guidance outside of school, how did it help you? *

When you consider sitting for the Leaving Certificate, what are your concerns in order of importance? *

When you consider future 3rd level studies what concerns you most? *

If you have considered pursuing a PLC at a Further Learning Institute, please list which ones.

Secondary School *

Year of Leaving Certificate *

List Subjects Currently Being Studied (Please note O / H & Recent Grades Per Subject). *

If not listed above, what foreign language do you plan taking in the leaving certificate? *

If you are taking grinds for any subjects, please list them.

If you are not sitting Irish in the Leaving Certificate, have you completed your exemption forms? *

If you want to answer the following please do so, are you eligible for either DARE or HEAR?

Are you aware of any career aspirations you may have?

Leave aside anticipated leaving certificate grades, in a perfect world, what would you like to study in college or university? *

Referencing your answers to the previous question, why would you like to pursue these studies? *

What courses (if any) are you currently considering putting down on your CAO Application? *

Are there specific universities, colleges, or vocational institutions you are considering? *

List any extracurricular activities, hobbies, or interests you may have.

Are there any skills that could be relevant to an academic / career discussion that have you developed during your secondary school years?

Do you play any sports, if yes, please list in order of preference.

Do you belong to any clubs and or associations, if yes, please list them?

Are there any challenges or concerns you would like to discuss? *

Is there any additional information about yourself or your aspirations that you would like to share?

I consent to the collection and use of the information provided for the purpose of academic and career

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