I. Personal Information

Please attach a
Passport-size Photo taken within the last six months

Full Name: 

Date of Birth (mm/dd/yyyy): 

Place of Birth: _________________________________________

Gender: pMale pFemale   Marital Status: p Single p Married

Citizenship (Nationality): ________________________________

Current Address: ______________________________________________________________
                                  street                                                                    
                            ______________________________________________________________
                                  city                                                                  state          zipcode 

Current Phone: (         ) ________________

Email:_______________________________________________

Permanent Address: ___________________________________________________________
                                  street                                                                    
                                 ___________________________________________________________
                                   city                                                                  state          zipcode 

Permanent Phone:  (         ) ______________

Emergency Contact (Name and Phone): ___________________________________________

	
II. Professional Qualifications

Educational Background:  List all your educational degrees. 
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Teaching Certificates:  List all your teaching-related certificates.
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Teaching Experience (Institution, Dates, Subject):
______________________________________________________________________________________
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Other Employment (Company, Dates, Duties):
______________________________________________________________________________________
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International Experiences (Country, Dates, Activities):
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Extracurricular Activities (Organization, Dates, Activities):
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III. Knowledge of Korea

Have you ever visited Korea before?  If yes, please explain duration and purpose.
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What is your knowledge of the Korean language? p Advanced p Intermediate p Basic p None

Please choose your preferred school area: p Rural area    p City area	

IV. Personal Essay
Please attach a typed essay of no more than 500 words describing yourself and your reasons for applying to this program.

V. Required Documentation
 D Resume   D Application and Personal Essay  D Official Medical Report  D Two Letters of Recommendation  D Diploma (Original or Notarized copy)  D Passport copy (photo page)  D Two Passport-size photos  D Transcript  D Teacher or TESOL Certificate(if you have) D Criminal Record D A Document of proving teaching career(if you have)

I certify that all of the above information concerning myself and my background are true to the best of my knowledge.  If I am selected as a successful participant, I agree to abide by the contract.

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      Signature                                                                                                                       Date