Spanish Resource Centre, York University,

4700 Keele Street, #229 York Lanes, Toronto, Canada, M3J 1P3,

Tel:(416) 650-8036, Fax: (416) 736-5696

E-mail:


SUMMER COURSES IN SPANISH UNIVERSITIES, Summer-2004
(for Teachers of Spanish in USA and Canada)
APPLICATION FORM

1. PERSONAL INFORMATION

Last Name
First Name
Gender: Male Female
Date of birth:
Passport Number: Expiration date:
Citizenship of Passport:
Home Address:
City: State or Province:
Zip code: Country:
Home Phone: Work Phone:
Email:
Full name to notify in case of emergency:
Relationship:
Address:
City: State or Province:
Zip Code: Country:
Home Phone: Work Phone:
Email:
School Name:
School District:
School Address:
City: State or Province:
Zip Code: Country:
School Phone: School Fax:
School Email:

2. EDUCATIONAL BACKGROUND

Highest level of education attained: BA BS MA MS Ph.D.
Undergraduate Institution/s:

Major:

Major:

Major:

Graduate Institution/s:

Major:

Major:

Major:

Postgraduate Work/Courses:

3. PROFESSIONAL INFORMATION

Present Teaching Assignment:
Number of years you have taught:
Level: K-5 6-8 9-12 Community College Other
If Other please specify:
Number of years you have taught Spanish: Position:
Grade Levels:
Do you teach Spanish-speaking students? Yes No
If you do, Program: Bilingual Dual Immersion Others
If Others please specify:
Number of years you have taught Spanish-speaking students:
Position:

4. KNOWLEDGE OF SPANISH AND SPAIN

Native speaker
Proficient
Upper-Intermediate
Have you ever traveled to Spain?
Yes No

5. HOW DID YOU HEAR ABOUT THIS PROGRAM?

Education Office/Department of Education
Leaflet
Teacher's Convention (ACTFL, AATSP, etc.)
The Web
A colleague/friend, etc.
Others (please specify):


6. TALKING ABOUT YOUR EXPERIENCE IN A SPANISH UNIVERSITY

In case you are granted the full scholarship which one of the following options you prefer after your return in Canada:

Present a workshop either at the Spanish Resource Centre or within the OMLTA’s Annual Spring Congress the following year;

Grant an interview to / write an article for Spanish Media;

Write an article for OMLTA’s magazine Communication describing your experience.

7. PLEASE ATTACH 2 LETTERS OF RECOMMENDATION:

Referee’s name:

Contact information:

Position:

Institution/Department:

Referee’s name:

Contact information:

Position:

Institution/Department:

8. PERSONAL STATEMENT EXPRESSING MOTIVATION TO APPLY FOR THIS GRANT

This essay will be used to assess your level of Spanish.

RESPUESTA PERSONAL: Por favor, responda en español (Entre 250 y 500 palabras).

Describa brevemente su situación actual en la enseñanza incluyendo la siguiente información: Alumnado, Niveles, Metodología Utilizada Beneficios que usted espera obtener con este programa

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