===== PAGE 1 ===== Your parent(s)/guardian(s) must complete Part 2 and submit this form at their local DSP Intreo Centre. Keep a photocopy and proof of postage. Post all documents to reach CAO by Wednesday 10 March 2027 at 5pm. It is the responsibility of every applicant to ensure both pages of this form are filled in correctly.
Part 1: To be completed by HEAR Applicant
HEAR Applicant's Name: Address:
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CAO Number: Date of Birth: DD M M Y Y Y Y PPS Number: ## Part 2: To be completed by applicant's Parent(s)/Guardian(s) I authorise the release of information outlined below for the purposes of assessing a HEAR application. Parent 1/Guardian 1 Signature Parent 2/Guardian 2 Signature
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PPS Number (Parent 1/Guardian 1) PPS Number (Parent 2/Guardian 2) ## Part 3: To be completed by DSP Official Parent 1/Guardian 1 Name: ___
Please do not alter the year for which information is required on this form.
Total Social Welfare Income on all social welfare schemes*
previously paid to this PPS number in the year 2025?Image
In receipt of means-tested social assistance payment(s) for at least 26 weeks or 6 months in the year 2025? YES □ NO
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Name of Payment(s): ___ Payment 1:
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Payment 2: 𨱏*Excluding Child Benefit and certain supplements paid under the Supplementary Welfare Allowance schemes. This is page 1 of a 2 page form. Page 2 must be completed, signed and stamped. ===== PAGE 2 ===== Parent 2/Guardian 2 Name: ___ Please do not alter the year for which information is required on this form. Total Social Welfare Income on all social welfare schemes* previously paid to this PPS number in the year 2025?
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In receipt of means-tested social assistance payment(s) for at least 26 weeks or 6 months in the year 2025? YES NO Name of Payment(s): ___ Payment 1: Payment 2:*Excluding Child Benefit and certain supplements paid under the Supplementary Welfare Allowance schemes. ## Additional Payment Information 1. Is there an Adult Dependant on payments listed on this form? YES NO Name of Adult Dependant: ### 2. Are means deducted for payments? YES NO If yes, please enter amount of weekly means deducted Weekly means deducted for Parent 1/Guardian 1 in 2025 Weekly means deducted for Parent 2/Guardian 2 in 2025 All forms must be completed, signed and stamped by a DSP official. Forms that are not signed and stamped are invalid. Name of DSP Official (BLOCK CAPITALS): Date: D D M M Y Y Y Y
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Signature of DSP Official DSP Official Stamp HEAR is a college and university admissions scheme for school leavers, resident in the Republic of Ireland, who are under represented at Higher Education due to their socio-economic background.