International House Barcelona Teacher Training Department Cambridge Diploma in English Language Teaching to Adults Module 3 (DELTA) Enrolment procedure Candidates must complete and return this application form. In order to ensure a place on the course, you should submit your application by January 3rd 2016 for the January – March 2016 online Module 3 course. Late applications will be accepted after those dates only if there are still places available. Please email this form to training@bcn.ihes.com Once your application has been processed, you will be sent an email confirming acceptance onto the course. Course content and information The module 3 course has been especially designed by Roger Hunt, to give you specific guidance on your extended written assignment. We will be running the online Module 3 course from January 18th – March 25th 2016. The course will combine input style sessions / readings and online, followed by subsequent email contact with Shaun Sweeney (your online Module 3 DELTA tutor) via email. Your assignment has to be completed and submitted to us by Sunday April 3rd. The fee is: 325€ The price of the courses does not include the Cambridge fee (currently €100) which you also need to pay on acceptance onto the course Payment information You can pay for the course by one of the methods below. PLEASE NOTE: If you make a bank transfer from the UK or another EU country, please add 6 euros (UK) to the fee. If you pay from a bank account from the USA or outside the EU, please add 18 euros on to the cost of the course. Method 1. Direct bank transfer: Account name: Bank: IBAN number: Swift Code: International House Barcelona, S.L. Banc de Sabadell, Via Laietana 47, 08003 Barcelona IBAN ES84 0081 0057 34 0003159319 BSABESBB Please note – if your bank needs to know - this number is the required international transfer number and it breaks down as follows: Country: ES84; Bank name: 0081; branch: 0057; bank’s internal sort code: 34; IH’s account number: 0003159319 Note: USE YOUR NAME AND THE COURSE CODE: DELTA Module AS A REFERENCE FOR BANK PAYMENTS SCAN THE PROOF OF PAYMENT to training@bcn.ihes.com to secure your place. Method 2. Credit card – but only in person You can pay for the course by Visa, Mastercard, or American Express. For further information and returning your application form: Teacher Training Department International House Trafalgar, 14 08010 Barcelona Tel. +34 93 268 45 11 E-mail training@bcn.ihes.com International House Barcelona Teacher Training Department Cambridge Diploma in English Language Teaching to Adults DELTA Module 3 (DELTA) APPLICATION online Module 3 course Jan 18th – March 26th 2016 Date of application: 1. PERSONAL DETAILS Surname Mr Mrs Ms First name(s) Date of birth Place of birth Nationality First Language Email Skype Present address Address Postcode Country Phone Work Name & Address Director/DoS* Phone Email *To be contacted for further information if necessary 2. DELTA course taken at IH BCN Please give details of when you took the DELTA course at IH BCN and whether you have passed module 1 and module 2. DELTA course: dates 3. Module 1 exam: date: grade Module 2 class: date: grade How did you hear about the Module 3 Diploma Course at International House Barcelona?