CELTA Course Application Form | Globally Speaking

Date *

Last name *

First name *

Title

Date of birth *

Place of birth *

First Language *

Nationality *

Address *

Telephone number *

Email *

English Language Certification

Other Languages (incl. CEFR level)

Education (incl. dates, qualifications, awarding bodies etc.)

English language teaching experience

Other relevant experience (incl. dates, organizations etc.)

General Health Do you have a history of any of the following?

Mental Health:

Anxiety

Yes

No

Depression

Yes

No

Other (Please specify)

Physical Health:

Diabetes

Yes

No

Epilepsy

Yes

No

Other (Please specify)

Learning differences:

Dyslexia

Yes

No

Dysgraphia

Yes

No

Other (Please specify)

We require this information in order to be able to advise you as to the most suitable course format and to provide you with the necessary support. For example, if you have been diagnosed with dyslexia you are eligible for extended assignment deadlines.

Other relevant information

References

Interview

Reasons for applying for the course (150-180 words)

CELTA COURSE

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