INTENSIVE SEMINAR - APPLICATION FORM A(TEACHER)

This is a fillable WORD form. Please TYPE your responses.

PERSONAL INFORMATIONTITLE      GIVEN NAME      SURNAME      FULL NAME IN KATAKANA      TEACHING NUMBER      TEACHING LOAD (FTE) (eg: 1.0)      

CONTACT INFORMATIONSCHOOL NAME      SCHOOL SECTOR GOVERNMENT INDEPENDENT CATHOLICSCHOOL ADDRESS      TOWN       STATE       POSTCODE      

HOME ADDRESS      TOWN       STATE       POSTCODE      MOBILE NUMBER      EMAIL      

ACADEMIC QUALIFICATIONS (INCLUDING TEACHING METHODOLOGY) UNIVERSITY / TAFE NAME DEGREE/COURSE YEAR

(eg:2005-2009)                                                                                     

JAPANESE LANGUAGE EXPERIENCE (OTHER THAN UNIVERSITY DEGREE)INSTITUTION NAME COURSE YEAR APPROXIMATE HOURS

(Eg) Waseda University Summer course 2005 July – Aug 60 hours                                                                                            

JAPANESE LANGUAGE TEACHING EXPERIENCEINSTITUTION NAME GRADES TAUGHT DURATION

                                                                    

CURRENT JAPANESE TEACHING LOADGRADE HOURS PER WEEK TEXTBOOK/RESOURCES USED

                                                                                                      

PREVIOUS STAYS IN JAPANLOCATION YEAR & DURATION

(eg: 2010, 1 month)PURPOSE

                                                                                     

HAVE YOU APPLIED FOR PREVIOUS INTENSIVE SEMINARS? IF YES, GIVE DETAILS.     

HAVE YOU PARTICIPATED IN PREVIOUS INTENSIVE SEMINARS? IF YES, GIVE DETAILS.     

IF SELECTED TO ATTEND, WILL YOU REQUIRE ACCOMMODATION? No Yes (shared apartment)

Note: Please be aware that we cannot make any last minute bookings. WILL YOU RECEIVE ANY FUNDS FOR EXPENSES ASSOCIATED WITH ATTENDANCE AT THE SEMINAR (eg: Grants or scholarships from your school, sector etc.)?

No Yes (provide details below)

     

JAPANESE PROFICIENCYPlease tick one box as appropriate.

LISTENINGI am able to:

understand main ideas of complex spoken text on both concrete and abstract topics. understand main points of clear standard input on familiar matters. understand most information of immediate relevance and very basic personal information. understand familiar and very basic phrases.

SPEAKINGI am able to:

interact with fluency and spontaneity and clearly explain points of view. interact in familiar situations and describe experiences and plans, giving reasons. communicate in simple and routine interactions. greet people, introduce myself and answer questions about personal details.

READING I am able to:

read and get the gist of news articles and websites. read and understand text on familiar matters encountered in daily life. read and understand survival information containing very basic kanji. read simple text in kana (hiragana and katakana) on very basic information.

WRITINGI am able to:

produce detailed text on a wide range of subjects and explain points of view. produce connected text on a variety of topics which are familiar or of personal interest. produce simple text on aspects of my background and immediate environment. produce short, simple text on basic familiar topics.

Can you write hiragana? No Yes

Can you write katakana? No Yes

How many kanji can you write? 0100 101500 5011000 1001+

HAVE YOU EVER TAKEN THE JAPANESE LANGUAGE PROFICIENCY TEST (JLPT)? No Yes (provide details below)

LEVEL (1-4 or N1-N5) YEAR CERTIFICATE NUMBER