DEIREADH SEACHTAINE NA GAEILGE
REGISTRATION FORM

 * indicates required field.
Ainm *
Seoladh *
Cathair * Stát * Cód a Phoist *

Guthán:   
Ríomhsheoladh: *
An bhfuil rogha comrádaí seomra agat (roommate preference)?

An bhfuil tú i do mhúinteoir faoi láthair? Tá Níl
Má tá, cá bhfuil tú ag múineadh?

Cá fhad (how long) a bhfuil tú ag foghlaim na Gaeilge?

Cén leibhéal?
Fáinne Airgid .........nó a choibhéis
Fáinne Oir .............nó a choibhéis
Cainteoir Dúchais
Rogha Lóin ar an Satharn:*
Hamburger
Cheeseburger
Chicken Caesar Salad
Vegetarian Meal
Rogha Dinnéir Oíche Dé Sathairn:*
Chicken Marsala
Salmon With Dill Sauce
Prime Rib Of Beef
Vegetarian Meal

An mbeadh suim agat i gceardlann nó léacht a thabairt dúinn? (Má's é do thoil é!)
  Bheadh Ní Bheadh

Dá mbeadh, cuir síos faoi, má's é do thoil é.
Ar uair na práinne, cuir glaoch ar:
Ainm Guthán:   

PAYMENT

$130.00
nó
$180.00 má tá seomra codlata príobháideach uait

You can register on the Web and pay by credit/debit card or print out this form and pay by check or money order.

Register on Web with Credit/Debit Card and PayPal

Print Form and Pay by Check:
Make your check payable to Daltaí na Gaeilge and mail it to:

Daltaí na Gaeilge
Liam Guidry
279 Park Ave.
Elberon, NJ 07740

If confirmation of your reservation is required, please enclose a stamped, self-addressed envelope with your Registration Form.

Ceisteanna?

Cuir glaoch ar Liam (732) 571-1988 nó Pádraig at (732) 291-5426.
Information and Directions
Events
February Weekend | Teachers Workshop | Advanced Speakers Weekend
May Weekend | June - Irish Saturday | Summer Week
November Weekend

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