I am travelling to Northern Ireland - is this the correct application form?
No. This application form is for visas for the Republic of Ireland only. If you wish to travel to Northern Ireland (Counties Antrim, Armagh, Derry, Down, Fermanagh and Tyrone) you will require a UK visa. However, if you wish to enter the Republic of Ireland at any time during your stay in Northern Ireland, you will also require an Irish visa.