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CONVERSATION ASSISTANT APPLICATION FORM
Academic Course
Academic Course *
PERSONAL DETAILS
Full name as shown on your passport Date of birth (day/month/year) Male/Female
* //* Male Female *
Mobile phone (mandatory) Home phone Passport number
* *
Nationality (also include if dual) Mother tongue language Address
* * *
City/Town Province/Region Post/Zip Code Country
* * * *
Email Address Skype Contact Emergency contact name & number
* * *
Marital status Do you have any children?
* *
Where did you hear about our programme? Please, give detailed information "Indicate availability: Full programme (Sep-June) or Other ( Indicate dates)"
* *
PERSONAL INFORMATION
Do you have any dietary restrictions/requirements? If yes, please give details.
*
"Do you have any minor (e.g. dust, smoke, fur) or major (e.g. nuts, gluten, penicillin) allergies? If yes, please give details."
*
Would you have any issues living with domestic pets? If yes, please give details.
*
Do you smoke? Yes    No *
Would you have any issues living in an environment where there could be smokers?
*
What is your Religion?
*
Please indicate if you have had any prior or currently have any medical condition(s), or have received treatment of any kind related to your health within the last 5 years. If yes, please give details.
*
Please, indicate if you are receiving any financial/welfare benefits.
*
Do you have sufficient funds to cover the cost of your flights and extra money if needed to cover some personal expenses or in the case of an emergency whilst in Spain?
*
Have you ever been convicted of a criminal offence? If yes, please give details.
*
Are you flexible regarding school location? If not, please tell us your preference and why.
*
Do you have any particular preferences regarding the age of the students? Please, tick one or more.
Flexible Infant (3-5 years old) Primary (6-12 years old) Secondary (13-16 years old) Sixth Form(16-18 years old)  *
Please, indicate if you have any visible tattoos/dreadlocks/piercings (other than standard). If yes, please give details.
Yes    No  *
Please, be aware that a school could ask for these to be removed/covered/taken out whilst working with the students.
EDUCATION AND TRAINING. Current or Last School, College, University attended/attending
Any sections related to Education which are not applicable, please, indicate with N/A
Pre-University Studies*
Name of the institution *
Studies *
City / Town *
Started(day/month/year) //* Ended (or indicate when due to complete)(day/month/year) //*
Qualification/s obtained *
* Pre-University Definition: EU Studies; A-levels, Highers, NVQ, or equivalent. NON EU Studies; High school diploma, Honors Graduation Diploma, or equivalent
University Studies
Name of the institution
Studies
City / Town
Started(day/month/year) // Ended (or indicate when due to complete)(day/month/year) //
Qualification/s obtained
Do you have any teaching qualifications (TEFL / CELTA or equivalent)
Name of institution provider and qualification obtained
"Certified hours completed if applicable"
Date obtained(day/month/year) //
Please, indicate if you have any experience within a formal educational environment (e.g. as a teacher, monitor, instructor etc. in a school, college, camps, etc.). If yes, please give details for example your role, responsibilities, name of company/institution, dates and any formal qualifications obtained.
Any other qualifications to emphasize?
Do you have any general informal experience with children? For example, babysitting, nannying, aupair, etc. If yes, please give details
Have you ever worked or studied abroad before? If yes, please give details.
Please note that an existing level of Spanish is not required to apply. However, if you know any additional languages apart from English, indicate your level (reading, writing, conversational).
Language Level
WORK EXPERIENCE (if any)
*
REFERENCES
"Reference 1 Obligatory Professional, Current or previous employer/ tutor/ organisation/ charity " Contact Number Email
* * *
Reference 2 Obligatory, Another Professional or Personal Contact Number Email
* * *
DESCRIBE YOURSELF INDICATING YOUR SOCIAL SKILLS/PERSONALITY/ STRENGTHS ETC..
*
WHY DO YOU THINK YOU WOULD BE A GOOD CONVERSATION ASSISTANT?
*
WHAT DO YOU EXPECT TO GAIN FROM THE PROGRAM?
*
FUTURE PROSPECTIVES
*
Please indicate any other information that you feel may be relevant to your application
PLEASE UPLOAD A NICE PROFILE PICTURE OF YOURSELF
This photo will be sent to prospective schools with your application.