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PART 1 To be completed by the HEAR applicant
CAO application number	Applicant name (BLOCK CAPITALS)
Applicant date of birth (DD / MM / YYYY)	Applicant PPS number
Address line 1
Address line 2
City or town	County	Eircode
Child details
Child's full name (BLOCK CAPITALS)	Child's date of birth (DD / MM / YYYY)
PART 2 To be completed by a DSP official at the local Intreo Centre
DSP official name (BLOCK CAPITALS)	Job title
Name of Intreo Centre (BLOCK CAPITALS)
City or town	County	Eircode
Is the above-named applicant in receipt of Child Benefit? ☐ Yes ☐ No
The DSP official must confirm that the applicant is in receipt of Child Benefit. This form must be signed and stamped by the DSP official. Forms that are not signed and stamped will not be accepted.
PART 3 DSP official signature and stamp
「コ1 [F2]	Signature of DSP official	OFFICIAL DSP STAMP Intreo Centre
Post completed form to:

• If you wish to apply under the HEAR Priority Group for Young Parents, you must complete your online HEAR application as well as sending this form. The deadline to complete your online HEAR application is Monday 1 March 2027 at 5pm. To be eligible for this priority group, you must also be eligible under HEAR Criterion 1: Low Income. • Complete all three parts of this form. Print clearly in BLOCK CAPITALS. • A Department of Social Protection (DSP) official must complete Part 2 at your local Intreo Centre. Post the completed form to CAO, Tower House, Eglinton Street, Galway. Deadline: Wednesday 10 March 2027 at 5pm. Keep a photocopy of this form. Request your proof of postage for free from An Post when you post it. ## PART 1 To be completed by the HEAR applicant HEAR Applications 2027 | CAO, Tower House, Eglinton Street, Galway | Deadline: Wednesday 10 March 2027 at 5pm HEAR is a college and university admissions scheme for school leavers in the Republic of Ireland who are underrepresented in Higher Education. Young Parents qualify as a HEAR Priority Group and must also provide evidence of household income to be considered eligible. For further support visit www.accesscollege.ie