Application for a Faculty Position

Last Revised Date: March 25, 2008

Position of Interest:

Application Date:

Personal Information

Surname:
Given Name: / Gender: Male Female
Nationality: / Marital Status: Single Married
Current Mobile/Home phone number: / Fax number:
Current Address:
Current Email:
Permanent Address (Home of Record):
Teaching Certification/License: Yes, No
Certificate Subject/Type:
Grade Level: Date of Expiry:
Place & Date of Issue:
How many dependents do you have? (<18 years old):
For Local Expatriate Applicant only
Type of valid Visa in China: Z (work) F (business) L(tourist) X (student)
Others: Visa expiry date:

Additional Personal Information

Name of Spouse:
Nationality: / Spouse’s Occupation:
Company’s Name Address:
If spouse is a teacher, please indicate his/her subject area(s):
Name of Dependent (child) / Date of Birth / Present Grade
Other information:

Confidential Placement Files are available from:

ISS SEARCH CIS Others:


Teaching Experiences (please begin with most recent School)

Year/Month / School / Position / Full time (F)
Part time (P)
F P
F P
F P
F P
F P
More spaces for you:
Summary of Full Time Teaching Years:
Lower Elementary (Early Childhood 3/4-Grade 2): Upper Elementary (Grade 3-5):
Middle School (Grade 6-8): High School (Grade 9-12):

Educational Qualification Information

Year/Month / College/University / Degree/Diploma/Certification

Educational Philosophy

Extra Curricular Activities

Please list activities you would like to sponsor or coach:

Health Disclosure

Please indicate any pre-existing medical illness/conditions:

References

Name / School Name / Position/Title / Mobile/Home/Office Tel. No.

*Please check this box as consent for QISS to contact your referees

*Please check this box to guarantee that all the information supplied above is true and accurate to the

best of your knowledge.

End of form

Please send us the following (please note that we will not be able to process your application until we
received the following documents)
- This duly completed application form
- Photocopies of your highest degree/diploma
- Photocopies of your teaching license
- A copy of the passport (photo page)
1. A copy of ID card for Host Country applicant
2. A copy of valid China visa page for Local Expatriate applicant
3. 2 – 3 Reference letters from previous employers confirming full time teaching experiences
TO:
I. by email
II. 86-532-88908876 by fax.
III. 70 Songling Road (Inside Qingdao No.2 Middle School ),Qingdao,China 266061