1. Pascal Connect application form 2016 .pdf

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Original filename: 1. Pascal Connect application form 2016.pdf
Author: Paul Clement

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Pascal Connect English School
Employment Application Form

1 - General Information:
First name

Last name

Date of birth

Gender

Country of birth

Mother tongue

If you hold any passports other than from your country of birth, please list them here:

2 - Current Contact Details:
Email address

Current address

Skype name

Best contact time
(please include time
zone)

3 - Additional questions:
A - Are you available for employment starting immediately and running until June 30, 2017?
B - Do you have any on-going physical or emotional illnesses or disabilities that you think
could interfere with your ability to do this job? (If yes, please provide details)
C - Have you had any major illnesses or operations over the past 3 years that you think could
interfere with your ability to do this job? (If yes, please provide details)
D - Have you ever been convicted of a criminal offence? (If yes, please provide details)
E - What interests you about teaching English?
F - What interests you about teaching English in Poland?
G - Please list three of your personal interests.

H - Please list three goals you hope to achieve in the next five years.
I – Do you hold a valid driver's licence?
J – Please list (a maximum of five) computer programs or online teaching tools that you are
able to use effectively.
K – Please complete the following table, where applicable, showing your teaching experience.
Students

Approximate hours of
teaching experience

Under five years old
Five to seven
Eight to twelve
Thirteen to fifteen
Sixteen to eighteen
Over eighteen
Exam preparation classes
(e.g. FCE, IELTS)
L – Which ages and levels, if any, do you prefer teaching?

Levels (e.g. Beginner,
intermediate, advanced)


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