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Apply Online Camp Programme

I am applying for a position as a Camp Teacher * indicates mandatory fields A. Personal Details Surname*: First name*: Middle name: Sex*: M F Date of birth*: City of birth*: Country of birth*: Nationality at birth*: Nationality*: Native Language*: Second language: Third language: Current contact address*: Postal code: Tel.: Skype address: E-mail address*: E-mail address (alternate): Do you hold a valid Passport?* Yes No  (if yes, complete this section) Country of issue: Passport number: Expiry date: In which country will you apply for a visa: Nearest Russian consulate in that country: Date available from*: Preferred posting (first choice): Preferred posting (second choice): I am prepared to be flexible*: Y N Encumbrances (all questions must be answered) Knowing that summer camps usually run from early June through mid-August, do you know of any reason that might make it difficult for you to fulfill your summer camp contract (e.g. family or other obligations)?*: Y N Do you have any medical conditions that require medication or periodic medical care?*: Y N Are you physically fit and able to participate in sports activities, nature walks and other extra-curricular activities?* : Y N B. Educational Details Highest Academic Qualification*: University: Major: Graduation Date: Minor: C. EFL Qualifications Do you hold a TEFL Qualification?* (if 'yes', please complete this section. If 'no', go on to section D) Y N CELTA Trinity TESOL TEFL/ TESL DELTA Trinity Licentiate BA/ MA TESOL Training college*: Location*: Graduation date*: Final grade*: Course duration*: Teaching practice*: Y N Tutor's name*: Email*: Tel. Number: D. EFL Experience Do you have formal experience teaching English as a Foreign Language? * Yes No   If 'yes', please complete this section. If 'no', please go directly to Section E. 1) Name of school: From: To: Referee: Telephone No.: E-mail Address: 2) Name of school: From: To: Referee: Telephone No.: E-mail Address: Have you ever taught General English?* Yes No   If yes, which levels of General English have you taught? Beginners Intermediate Elementary Upper-intermediate Pre-intermediate Advanced Please list the names of any coursebooks that you have used to teach General English. Have you ever taught International Examination classes?* Yes No   If yes, which International Examination classes have you taught? FCE IELTS CAE TOEFL CPE Other Please list the names of any coursebooks that you have used to teach International Examinations. Have you ever taught Young Learner Classes?* Yes No   If yes, which age groups have you taught? 4-5 year olds 11-13 year olds 6-10 year olds 14-16 year olds Please list the names of any coursebooks that you have used to teach young learners. Have you ever... taught in-company taught English for Specific Purposes (ESP) taught Business English taught English online What size classes have you taught*? Individual students (1 to 1) Groups from 9 - 12 students Small groups up to 8 students Large groups > 12 students E. Camp Experience Please list any previous summer camp teaching experiences (experience can be any summer camp focused on young people and not necessarily a language camp). Yes No Camp No. 1: Location: From: To: Your role: Referee: E­mail: Camp No. 2: Location: From: To: Your role: Referee: E­mail: First Aid Do you have first aid or CPR training?* Yes No Do you have a lifeguard certificate?*    Yes No F. Extracurricular Profile Have you ever worked with children or young people other than that which you may have described above; e.g. volunteer capacity, coaching? paid or unpaid?* Describe any organizations and activities you have been engaged in (sports teams, community service, etc).* Have you been recognized for good performance in any organization you have participated in (consider jobs, volunteer work, academic excellence, etc.)?* Do you have any other experience you would like us to know about which may be relevant to your application?* G. Personal Profile How would you describe yourself?* Please describe your interests and hobbies. What do you do in your free time?* What are you doing at the moment?* Why do you want to teach at a camp?* How would you be a good role model to your campers?* Have you ever been to Russia?* YesNo If yes, when: Have you ever been arrested/ convicted of a criminal offence?* YesNo H. Professional and Academic References Please provide the names and contact information of two referees who have known you in either a professional or academic capacity Referee No. 1 Contact Information Referee No. 2 Contact Information Name:* Title*: E-Mail:* Tel.: Fax: Name:* Title*: E-Mail:* Tel.: Fax: NB. For ease and efficiency of communication, e-mail addresses are preferable. I. Where You Heard About Us Where did you find out about this Language Link Job Opportunity?* goabroad.com www.tefl.com From a friend studyabroad.com Transitions Abroad website From my university studyabroadlinks.com Transitions Abroad magazine Other (please state) Language Link website www.languagelink.ru Russian Life J. Declaration I declare that I have not knowingly made any false statements in this application form. I understand that the giving of false information may result in my expulsion from the Language Link programme.* I agree