[ { "page": 1, "items": [ { "page": 1, "type": "TEXT", "location": { "l": 237.2946, "t": 806.1313, "r": 492.1044, "b": 750.9332 }, "text": "Educational Impact Statement 2027", "reading_order": 0 }, { "page": 1, "type": "TEXT", "location": { "l": 46.5472, "t": 794.6117, "r": 207.3029, "b": 763.8928 }, "text": "Section B:", "reading_order": 1 }, { "page": 1, "type": "TITLE", "location": { "l": 41.0287, "t": 728.854, "r": 236.8148, "b": 713.9746 }, "text": "Instructions for completion:", "reading_order": 2, "level": 3 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 40.3089, "t": 710.8547, "r": 534.8127, "b": 674.616 }, "text": "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.", "list_id": "L1", "level": 0, "reading_order": 3 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 40.3089, "t": 673.176, "r": 523.0559, "b": 637.4173 }, "text": "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.", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 4 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 40.7888, "t": 635.9773, "r": 460.4331, "b": 623.7378 }, "text": "EIS forms completed by a PLC or FET college will not be considered in determining DARE eligibility.", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 5 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 41.0287, "t": 622.2978, "r": 526.8948, "b": 598.7787 }, "text": "A Teacher's Manual has been circulated to all schools to provide guidelines on how to complete the Educational Impact Statement.", "marker": "•", "list_id": "L1", "level": 0, "reading_order": 6 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 41.2686, "t": 597.0987, "r": 531.6935, "b": 573.0996 }, "text": "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.", "list_id": "L1", "level": 0, "reading_order": 7 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 41.5086, "t": 571.4196, "r": 528.0945, "b": 547.4205 }, "text": "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.", "marker": "-", "list_id": "L1", "level": 0, "reading_order": 8 }, { "page": 1, "type": "TITLE", "location": { "l": 41.5086, "t": 542.1407, "r": 553.2876, "b": 525.8213 }, "text": "Tips for Schools on how to complete the Educational Impact Statement:", "reading_order": 9, "level": 3 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 40.5488, "t": 523.6613, "r": 547.5292, "b": 499.6622 }, "text": "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.", "marker": "•", "list_id": "L2", "level": 0, "reading_order": 10 }, { "page": 1, "type": "LIST_ITEM", "location": { "l": 40.7888, "t": 497.9823, "r": 534.8127, "b": 473.7431 }, "text": "Using the Educational Impact Statement checklist, consult with the applicant about how their disability has impacted upon their educational experience in your school.", "list_id": "L2", "level": 0, "reading_order": 11 }, { "page": 1, "type": "TEXT", "location": { "l": 41.0287, "t": 472.7832, "r": 514.4183, "b": 448.304 }, "text": "Not all sections will be relevant to all applicants. You may need to gather information from sources in your school depending on which sections are relevant.", "reading_order": 12 }, { "page": 1, "type": "TEXT", "location": { "l": 40.5488, "t": 447.1041, "r": 393.2517, "b": 434.8645 }, "text": "When complete, ensure it is signed and stamped by the Principal/Deputy Principal.", "reading_order": 13 }, { "page": 1, "type": "TEXT", "location": { "l": 40.7888, "t": 433.9045, "r": 539.3714, "b": 408.7054 }, "text": "Remind DARE applicants that they must return the Educational Impact Statement, along with the appropriate evidence of disability to DARE Applications 2027, CAO, Tower House, Eglinton Street, Galway by 10 March 2027.", "reading_order": 14 }, { "page": 1, "type": "TABLE", "location": { "l": 42.9482, "t": 394.066, "r": 558.5661, "b": 266.8705 }, "text": "
Applicant Details
Full Name of Applicant:
Date of Birth:\"Image\"\"
CAO Number:\"Image\"\"
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First Attended:MM
Completion (or expected completion):[F3][F22]
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School Name:
School Address:
School Roll Number:
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Yes ☐ No ☐", "marker": "4.", "list_id": "L3", "level": 0, "reading_order": 9 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 38.6294, "t": 502.7478, "r": 556.8866, "b": 480.0857 }, "text": "I have experienced other educational impact not listed above. Yes ☐ No ☐", "marker": "5.", "list_id": "L3", "level": 0, "reading_order": 10 }, { "page": 2, "type": "LIST_ITEM", "location": { "l": 38.6294, "t": 480.0857, "r": 556.8866, "b": 457.4237 }, "text": "My literacy and/or numeracy abilities have been impacted. Yes ☐ No ☐", "marker": "6.", "list_id": "L3", "level": 0, "reading_order": 11 }, { "page": 2, "type": "TITLE", "location": { "l": 38.8693, "t": 402.2257, "r": 552.5678, "b": 371.9867 }, "text": "1.1 Has the applicant received additional support in school due to the impact of their disability? 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YearNumber of Days AbsentYearNumber of Days Absent
1st Year4th Year
2nd Year5th Year
3rd Year6th Year
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"location": { "l": 40.069, "t": 266.3905, "r": 536.0123, "b": 226.5519 }, "text": "If yes, enter the number of partial days missed. Please describe the extent to which the applicant missed class during their time in post primary education. Please also provide the reason(s) for this, e.g. personal care needs, appointments for learning support, fatigue, applicant needing to take breaks.", "reading_order": 17 } ] }, { "page": 4, "items": [ { "page": 4, "type": "TITLE", "location": { "l": 39.829, "t": 803.4914, "r": 368.0586, "b": 785.732 }, "text": "Indicator 3: School Experience and Well-being", "reading_order": 0, "level": 3 }, { "page": 4, "type": "TITLE", "location": { "l": 40.069, "t": 773.2524, "r": 446.7569, "b": 745.1734 }, "text": "3.1 Has the applicant's potential to participate fully in extra-curricular activities been constrained as a result of their disability/condition?", "reading_order": 1, "level": 2 }, { "page": 4, "type": "TEXT", "location": { "l": 450.116, "t": 748.2933, "r": 544.6499, "b": 727.8941 }, "text": "Yes ○ No ○", "reading_order": 2 }, { "page": 4, "type": "TITLE", "location": { "l": 38.6294, "t": 629.9776, "r": 490.185, "b": 600.9386 }, "text": "3.2 Has the applicant received support due to the emotional impact of the disability/condition from any of the following? 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Reading accuracy
Single word reading
Reading comprehension
Pseudoword decoding
Reading speed
Spelling
Writing speed
Mathematical reasoning and problem solving
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