Thisapplicationformmustbe completedelectronically,printed,signedandthenscannedtothe

Administrator(oranelectronicsignatureis acceptable).Allrelevantsupportingdocuments,as listed,areto

besubmittedwiththeapplication.Pleasescanandsubmitalldocumentselectronically.Theapplicationform mustbefullycompleteforittobeconsidered.

1. PersonalDetails

Surname / FirstName(s) / Title(e.g. Mr,Ms)
Contact address
Emailaddress / Telephone number (includeinternational codes)
Home: Work: / Home: Work:
Mobile:
Date of Application

2. Qualifications

Youmusthavetheminimumprofessionalrequirementsofanundergraduatedegree,pluseithera

TEFL/TESOL/EFL/ESOLcertificateor adegreewithaTESOLfocuses.

Degree/Diploma/Certificate / Institution(namelocation) / Dates ofstudy
(From–To)

3. Teaching Experience

Youmusthavea minimumof 3 years’full-timeTESOLteachingexperiencetoadultstudents(16years’and

over),orequivalentpart-time.

Name and address ofemployer
(includetelephonenumber and email address) / Average teaching hours per weekto adults(aged
16 or over) / First language of the majority of students / Focus of teaching (General English,Exam preparation, Business,EAP) / Dates of
employment (From–To, including
months)

Otherworkexperience

Name of Employer / Duties / Dates
(From–To)

4. Experienceasan accreditedassessor/ Examinerfor recognisedexaminations(national and international)

Examinationtitle(please describe the assessor role) / Examining body / Dates
(From–To)

5. Professionalattributesand interpersonalskills

a) Pleaserespond tothequestionsinAttachmentAofthis applicationform.

b)PleasesendtheReferenceTemplate to your refereetobecompletedconfidentiallyand emaileddirectlytothe recruitingcentre.

6. Englishlanguagecompetence HaveyoutakenanIELTStest? Yes/No If“Yes”,whatwasyourtestdate?

DATE:

Whatwasyourtestscore?

Listening: / Reading: / Writing: / Speaking: / Overall BandScore:

Pleaserespondtothequestionsin AttachmentBof thisapplicationform.Allapplicantsmustcomplete

AttachmentB.

7. PreviousIELTS Examinertraining

Haveyou ever..? / YES/NO / Date of application/
training / Centrewhereyou applied/
trained
PreviouslyappliedtobeanIELTS Examiner?
Participatedin IELTS Examiner Training?

8. Applicationformchecklist

Pleaseensurethatyou haveincludedwithyour application:

9. Declaration

Pleasereadand sign belowtoindicateyour agreement:

Ideclarethat the informationIhave providedinthisapplicationformisfullandaccurate,tothe best of my knowledgeandbelief, correct andcomplete.
Warning:ifyou include anydetailsthatyou knowto befalse or ifyouwithholdrelevantinformation,you may renderyourselfliabletodisqualificationfromtherecruitmentexercise or, ifinvitedto examine,totheInvitationto Examinebeingwithdrawn.In addition,IELTSAustraliaPtyLtd/BritishCouncil(whichever is appropriate)may seektorecover fromyou allcostsincurredbyus intherecruitment, certification andtrainingprocess andany other costsrelatingtoyourworkas anExaminer.
Name of applicant / Signature

Database- Please signbelow:

I amawarethat ifI become anIELTSExaminer,allIELTSspecific informationwillbepermanentlyheld ona databasewhichmaybe accessedbyeither Test Partner, Examiner Support Coordinators(ESCs),Examiner Trainersor IELTS CentreAdministrators at anytime.
Name of applicant / Signature

Verificationofdocuments- Pleasesignbelow:

I agreetopaythe cost of verificationof anydocumentsrequested aspart ofthe IELTS Examiner recruitment process.
Name of applicant / Signature

IELTSTest- Please signbelow:

I agreetopaythe IELTS testfee if Iamrequiredtotake itas partoftheIELTSExaminer recruitment
process. All applicantsmustsignhere, evenifanIELTS test has alreadybeentakenor theyhaveEnglish as their firstlanguage.NBTheIELTS test fee isthesameasthat chargedtoIELTS candidatesat thecentre where you are applying.
Name of applicant / Signature

Recordingofinterview- Pleasesignbelow:

I agreeto allowIELTS torecordmyrecruitmentinterviewfor qualityassurancepurposes.
Name of applicant / Signature

Signatureanddateofapplication:

Applicantname
Applicant signature
Date of application

Pleasescan/emailthispagewithyoursignatureson.Thisdocumentiskeptfor2 yearsafteryoustop workingasanExaminer.

AttachmentA– ProfessionalAttributes andInterpersonalSkills

In thissection you arerequired to present evidence thatyouhave therequiredprofessional attributesandinterpersonal skillstobecomean IELTS Examiner(see number 4on theapplicationform).

Give detailsofasituationyouwere in,theactionyou tookand theoutcome foreach ofthequestionsbelow.Ifyouanswer onaseparatesheettosubmitwithyour application youmustinclude your nameoneachpage–writenomorethan 100 words for eachsituation.

1.Describea situationinyour professionallife inwhich effective communicationis important–howhaveyou ensuredthatyour own communicationis effective?

2.Describea situationinyour professionallifewhereyouhave hadtomaintainconfidentialityor follow proceduresto ensuresecurity.

3.Describeataskthatyou haveto complete accuratelyandin detail–howdoyou ensurethatyou complete thetasktotherequired standard?

4. Describeanoccasionwhenyoureceived and builtonguidanceandadvicefromothers.

5.What advicewouldyou givetoa newteacheronwhat isexpectedintermsofpunctuality,dress code,ways of addressingothersandanyother important aspects ofthe culturalcontextinwhichyouwork?

Pleaseensurethatall attachmentsare correctlylabelled with your nameand contactdetails.

AttachmentB– English Language Competence

AllApplicantsmust completethisattachment,regardless of nationalityandfirstlanguage.

PARTA

Read the followingstatementsandcircletheoneanswer thatmostaccuratelyreflects yourEnglishlanguage skills.

A1:WhenwatchingatelevisionprogrammeorvideoinEnglish,Icanunderstand

Everything / Most ofthetime / Often / Rarely / Never

A2:WhenwritingareportinEnglish,I canconveymythoughtsto expressmymeaning precisely.Icandothis

Easily / Most ofthetime / Often / Rarely / Never

A3:Iam ableto understanda varietyofStandardEnglishaccents

Easily / Most ofthetime / Often / Rarely / Never

A4:After readinga paragraphon languageteaching,Icansummariseitscontents

Easily / Most ofthetime / Often / Rarely / Never

PART B

Answer eachofthequestionsbelowin thespace provided.

B1:Whatwas themainlanguagespokeninyour homewhenyouwerea smallchild?
B2:Wereanyotherlanguagesspokeninyourhomewhenyouwerea child? Yes/No
If“Yes”, listtheadditionallanguages.
B3:At approximatelywhat agedidyoustarttospeakEnglishregularly?
B4:Whatwas themainlanguage ofinstructionwhenyou firststartedschool?
B5:Wereanyother languagesused inyour primary school? Yes/No
If“Yes”, listthelanguages.
B6:Whatwas themainlanguage ofinstructionatyoursecondaryschool(s)?
B7:Wasanyother language used for instructionatyoursecondary school? Yes/No
If“Yes”, namethelanguage(s).
B8:Were yourequired tostudyanotherlanguage ateither primaryorsecondaryschool? Yes/No
If“Yes”, namethelanguage(s).
B9:Whatwas themainlanguageofinstructionattertiarylevel?
B10:Whatlanguage(s) doyouusewhenrelaxingwith friends?
B11:Whatis the officiallanguage ofthecountryinwhichyou currently live?
B12:Howlonghaveyoulivedin thatcountry?
B13Haveyoudeliveredaconference paper inEnglish? Yes/No
If“Yes”,whatwas the topic?