QUALIFICATIONS RECOGNITION Application form For the Approval of your Initial English Language Teaching Qualification for the purposes of English language teaching (ELT) in the recognised ELT sector in Ireland. Please complete the application form by ticking and entering the appropriate data into the spaces provided. Email this form and the required documentation to: qualadvice@qqi.ie If you have a query before you send an application please contact Qualification Recognition at: http://www.qqi.ie/About/Pages/Contact_Us.aspx Please Note: INCOMPLETE APPLICATIONS WILL BE RETURNED TO THE APPLICANT SECTION 1a: REQUI RED DOCUMENTATI ON - ELT a. Your ELT Qualification/Parchment (degree, diploma, certificate etc.) in its original language ☐ b. An official translation of the qualification/parchment into English ☐ c. Your transcript/mark sheets/modules/list of subjects passed in original language ☐ d. An official translation of transcript/mark sheets/modules/list of subjects passed ☐ e. Documentation in support of name change (if applicable), e.g. marriage certificate or deed poll ☐ For further information, see Key Standards & Guidelines documentation on: http://www.acels.ie/acelselt.htm SECTION 1b: REQUIRED DOCUM ENTATION - LEVEL 7 QU ALIFIC ATIO N OR AB OVE a. Your qualification (degree, diploma, certificate etc.) in its original language ☐ b. An official translation of the qualification into English ☐ c. Your transcript/mark sheets/list of subjects passed in original language ☐ d. An official translation of transcript/mark sheets/list of subjects passed ☐ e. Documentation regarding your undergraduate qualification (if applicable) ☐ For further information on Major Awards visit: www.nfq.ie / www.qualrec.ie To check foreign qualification comparabilities already established, visit http://www.qualificationsrecognition.ie/qualification-recognition-service-database.html SECTION 2: APPLIC AN T DETAI LS Title Choose an item. First name Click here to enter text. Surname Click here to enter text. Previous name if changed (enclose documentation for change of name) Click here to enter text. Email address Click here to enter text. Home tel. Click here to enter text. Cell/Mobile tel. Click here to enter text. Postal address Click here to enter text. Town/City Click here to enter text. Country Click here to enter text. SECTION 3: INFORM ATION REG ARDI NG THE QU ALI FIC ATIO N Name of Educational Institution or Course Provider Click here to enter text. Web address Click here to enter text. E-mail address Click here to enter text. Postal Address (Street, City, Country) Click here to enter text. Status of Educational Institution Choose an item. QUALIFICATIONS RECOGNITION SECTION 3 cont’d: INFORM ATION REG ARDI NG THE QU ALI FIC ATIO N Name of Awarding Body (if different from Educational Institution or Course Provider) Click here to enter text. Web address and e-mail address Click here to enter text. Title of Qualification in Original Language Click here to enter text. Title of Qualification in English Click here to enter text. Year qualification was awarded Click here to enter text. Date started (dd/mm/yyyy) Click here to enter a date. Date completed (dd/mm/yyyy) Click here to enter a date. Name, phone number and e-mail address of official at Institution or Course Provider who can supply further details about course of study Click here to enter text. Study Mode Choose an item. Length of Programme of study according to curriculum. See Key Standards & Guidelines on: http://www.acels.ie/acelselt.htm Click here to enter text. Supervised classroom observation See Key Standards & Guidelines on: http://www.acels.ie/acelselt.htm Click here to enter text. Assessed classroom observation of real class time Teaching Practice See Key Standards & Guidelines on: http://www.acels.ie/acelselt.htm Click here to enter text. Trainer-directed study See Key Standards & Guidelines on: http://www.acels.ie/acelselt.htm Click here to enter text. Trainee Attendance Requirements: A minimum of 90% of the programmed hours were attended. ☐ A minimum of 95% of the face-to-face programme hours were attended. ☐ 100% attendance for each teaching practice was compulsory. ☐ SECTION 4: D AT A PRO TECTION In order to process your application accurately it may be necessary to forward your details to a third party body in Ireland or abroad. I AGREE to my personal information being sent to another body. (PLEASE TICK BOX) ☐ I DO NOT agree to my personal information being sent to another body. (PLEASE TICK BOX) ☐ SECTION 5: STATE MENT OF RESPONSIBILI TY I acknowledge responsibility for the accuracy and integrity of this Application and I confirm and certify that the information provided is correct in all material respects and that the documents provided are authentic and true copies of the originals. ☐ I further acknowledge and accept that that the furnishing of materially inaccurate information and/or false or misleading documentation could invalidate this Application. ☐ I accept that a breach of the foregoing commitments will entitle QQI to suspend all dealings with me/the Applicant for such period and subject to such conditions as QQI shall reasonably determine. ☐