CELTA initial application form 2014-15
Please complete this form carefully as it is used as the first stage of assessment for selection
Contact Details:
First Name:
Date of Birth:
Family Name:
Male
Nationality:
Country of Residence:
Female
First Language:
Contact Address:
Phone contact number(s):
Email:
Present Occupation:
Education:
1. Degree and post graduate qualifications:
Subject(s);
Date:
University/College + Location:
Subject(s);
Date:
University/College + Location:
Subject(s);
Date:
University/College + Location:
2. A levels or equivalent (please give full details of the type of qualification if not A level):
Subjects + grades
English qualifications/ level (e.g. GCSE, A level, Cambridge Proficiency, Cambridge Advanced Level)
If English is not your first language, please give an assessment of your level of English (Cambridge Proficiency Level or equivalent is
preferred)
Other Languages Spoken (please state level, e.g. fluent, survival level + any exams taken). Do you have any recent experience of
learning another language?
Do you have any teaching experience (it doesn’t have to be English)? Please give details (type of teaching, location, dates)
What are your interests outside work?
Have you ever lived or worked in another country? Please give details
Personal Statement:
Please write, in 250-300 words, your supporting statement for doing the course. What is your current occupation, what is your
educational background and training, what previous jobs have you had, why do you want to do this course at this time, what
experience and qualities do you think you will bring to the course? This supporting statement will be used in the selection process to
decide if you can proceed to the next stage of the application.
 What is the start date of the course you would like to join

(check web-site for options)? _______________
Support for Success: Do you have any Access Requirements for Interview? Yes
No
If Yes, please indicate if you wish the Learner Support Team to make access arrangements for you if you are asked to interview. This
information is only passed to staff who organise interview support.
To discuss this support, please contact the Learner Support Liaison Officer:
Voice: 020 8918 7486
TextPhone: 020 8918 7394
Communicator Support
Hearing Loop
Wheelchair Accessibility
Advocacy Support for Mental Health Issues or Other Disability
Orientation for Sight Difficulties
Other (please state requirements)
We make every effort to ensure that all information is accurate and current when published. Courses and services are subject to regular review; details may change at any time. All courses run
subject to demand.
Signature:
Please return completed form to:
CELTA Admissions Room W109,
South Thames College,
Wandsworth Campus,
Wandsworth High Street,
London, SW18 2PP
Date:
Email: teacher.education@south-thames.ac.uk