APPLICATION FORM
STAGE DU CIEP – Université d’été 2012 «BELC, les métiers du français dans le monde»
Nantes, France, du 2 au 27 juillet 2012
French Embassy in Canada and OMLTA/AOPLV scholarship for a member
Criteria for choosing the successful candidate
1. The applicant is a current member of OMLTA/AOPLV
2. Written submission of this application (pages 1 & 2)
3. A one page written letter is submitted in French from the applicant indicating why he/she wishes to attend this course and how he/she intends to provide the acquired knowledge among the community of teachers of French as a second language.
4. The third-party comment form (page 3). This form must be filled in by a person of the applicant's choice, professionally connected (Superintendent, principal, vice-principal, consultant, etc.) to provide a personalized comment on the application.
Submission only by email
Date of submission: application and documents must be received by Thursday, April 12th, 2012 to
and
Surname: First names:
Date and country of birth: Canadian citizenship: YES / NO (please circle)
Contact Home Address:
Phone number: day: evening:
Facsimile/e-mail:
EDUCATIONAL INSTITUTION:
Name of school : …………………………………………………......
School Board and/or school if applicable ......
Superintendent or Principal’s name: …………………………………………………………………………………………
Address: ……………………………………………………………...... …………………………………..
Phone: ………………………………………………… Fax: ……………………………………………….
E-mail: …………………………………………………………………………………………...... …………………
University qualifications (give main subjects and levels):
...... ………………………………………………………………………......
......
Year:
Teacher Training Qualifications: ………………………………………………………………………………….
List your current and past positions:
Institution / Date (from… to…) / Job title / Job descriptionCurrent, since……
List all training you have attended during the 5 last years:
………………………………………………………………………………………………………………………......
………………………………………………………………………………………………………………………......
………………………………………………………………………………………………………………………......
………………………………………………………………………………………………………………………......
List trips, visits or long stays in French-speaking countries:
Highest Qualification obtained in French (indicate date obtained):
………………………………………………………………………………………………………………………….
Estimate your written level of French(for more details, search “Common European Framework of Reference for Languages” in Wikipedia):
A1 A2 B1 B2 C1 C2
Estimate your oral level of French:
A1 A2 B1 B2 C1 C2
How do you anticipate using the knowledge acquired during the Université d’été du BELC?
…………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Date, Name: ......
STAGE DU CIEP – Université d’été 2012 «BELC, les métiers du français dans le monde»
Nantes, France, du 2 au 27 juillet 2012
French Embassy in Canada and OMLTA/AOPLV scholarship for a member
Third-party comment form
NOTE To the PERSON IN CHARGE OF COMMENTING ON THE APPLICATION:Ø You have been chosen by the applicant to provide a personalized comment on her/his application to the French. Embassy-OMLTA/AOPLV scholarship to the BELC, Université d’été 2012.
Ø Your comment is important to us, as it will help us to better understand the her/his profile, abilities and motivations.
Ø We may take the liberty to contact you, to ask for more details: in case you do not wish to be contacted, please do not leave you contact details below.
Ø In case you do not wish to fill in this form, and you prefer to make a comment over the phone, please do not fill the “Your comments” part and specify on the form that you prefer us to contact you. We will contact you only if we feel the need to do so.
Please complete this form and return it via email by Thursday 12th April 2012 to:
and
CONFIDENTIAL
Your details:
- SURNAME: First name:
- Job title:
- School board (and school if applicable):
- Phone and email:
APPLICANT’S NAME: ......
YOUR COMMENTS:
1. Please describe how you are professionally linked to the applicant:
2. Please list all or some of the professional activities you may have conducted with him/her:
3. Please give a personal recommendation and opinion on why the applicant deserves, or not, to be selected (optional).
Date, Name:
1
ApplicationForm_BELC-2012.doc
02/02/12