This form has a dual purpose. It is used along with evidence of disability documentation to help determine eligibility for applicants applying through DARE. The form also provides background information to colleges on the applicant's educational experience and helps to determine appropriate supports at third level.

The appropriate teacher in the school should complete the Educational Impact Statement (EIS) checklist with the applicant. That teacher should then complete the rest of this form. This form MUST be signed and stamped by the school principal or deputy principal.

EIS forms completed by a PLC or FET college will not be considered in determining DARE eligibility.

A Teacher's Manual has been circulated to all schools to provide guidelines on how to complete the Educational Impact Statement.

It is the applicant's responsibility to ensure all necessary sections of this form are completed and posted to the CAO. Remember to keep a photocopy.

DARE applicants must complete Section A, the online Supplementary Information Form (SIF) and tick YES to DARE under Question 1 by 17:00 on 1 March 2027.

You can save this form to your PC/laptop and enter the required information electronically. You may need to download Adobe Acrobat Reader DC to do this (click here to download Adobe). Alternatively, you can print it off and complete by hand.

Using the Educational Impact Statement checklist, consult with the applicant about how their disability has impacted upon their educational experience in your school.