CELTA Application Form Course date 1st Choice: Course date 2nd Choice(if applicable): 1. Personal Details Surname: First name(s): Date of birth: Nationality: Age at the start of the course: Mother Tongue: Address: Phone: Email address: 2. Education Please give name of qualification, name of institution, grades attained and year of completion: Institution Qualification Subject and grades Date/Year Secondary/High School Further/Higher Education 3. Languages Which languages do you speak/read/write? Please comment briefly on your level of proficiency in each: 4. Work experience General work experience. Employer Dates Responsibilities 5. Teaching experience (if any) Indicate your experience in teaching English as a Foreign Language, if any. Please give details of schools, dates, and type of teaching. (e.g. adults, informal, young learners, 0ne to 0ne etc.) Name of Institution Dates Type of Teaching 6. Please give reasons for doing the course, your future plans & why you feel you are suited to teaching English teaching ideas (max 80 words): 7. Language awareness a) Briefly explain the differences between the following words or phrases b) Say how you would clarify these differences to students 1 Slimand thin. to clarify 2 I’ve lived in Spain for 10 years and I lived in Spain for 10 years. to clarify 3 Can you lend us a tenner? andCould you lend me ten pounds? To clarify 8. Classroom awareness With reference to your own language learning experiences, what do you consider to be the most important factors which aid learning in a classroom? 9. Special Needs If there are any medical conditionsor personal circumstances that would affect your ability to complete the course, please give details below: In line with Cambridge ESOL Teaching Awards’ Equal Opportunities Policy, Language Testing Services (LTS) will make every effort to accommodate applicants with special requirements. Applicants with special requirements should be able to confirm that they have the necessary strategies and/or the personal and technical support to enable them to complete the course successfully. Language Testing Services (LTS) will make reasonable adjustments to the course programme and course delivery where necessary, and accepts their responsibilities in relation to legal requirements. The centre is required to confirm with Cambridge ESOL any special arrangements before accepting the candidate onto the course. If you have special requirements you are encouraged to familiarise themselves with the role of the teacher and the demands of the classroom in the field of ELT before accepting a place on the course. This can be through discussions with course tutors and visiting the centre beforehand. It may be possible to observe parts of a course taking place. If you think you will need extra time to complete assignments (e.g. for dyslexia) please speak to a member of the team. 10. Please tick/complete the relevant boxes: How did you hear about CELTA at Language Testing Services (LTS)?Please state which website if applicable. Why did you choose Language Testing Services (LTS)(and not another centre)? It is close Suitable dates Someone recommended it Price Other: 11. Reference Please write the names and contact information of a referee, either professional or academic. We reserve the right to contact them before acceptance on the course. Name: Position: Tel: E-mail: