The Application for CELTA Cambodia

Course Start Date *
Study Modes *
Please do NOT close this page until you have completed the required information.
Submitting the application form is free and will not commit the applicants in any way.
Payment will only be processed upon a successful interview.
Personal Information
Title *
First Names *
Surname *
Date of Birth *
Phone *
Email *
Nationality *
First Language *
Address *
Present Occupation*
Please attach a clear passport sized photograph of yourself in the box below (Maximum upload size: 2MB):
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Medical Issues
If you have any medical issues we need to be aware of please provide details below:
Medical Issue
Help Needed
Education & Qualifications
Institution *
Qualifications *
Start Date *
End Date *
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2nd Education & Qualifications
Institution
Qualifications
Start Date
End Date
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3rd Education & Qualifications
Institution
Qualifications
Start Date
End Date
Language Proficiency
If your first language is not English, please indicate your English proficiency below:
Proficiency Level
Spoken Proficiency
Written Proficiency
Listening Proficiency
Reading Proficiency
If you speak any other languages, please comment on your proficiency below:
Language
Proficiency
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2nd Language
Language
Proficiency
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3rd Language
Language
Proficiency
Tutor Comments:
Previous Teaching Experience
a. Please list any experience you have Teaching English to Speakers of Other Languages below:
Experience
Qualifications
b. Please list any relevant teaching or training experience you have below:
Experience
Qualifications
Please be aware that previous experience is not a requirement for CELTA courses
Referees
Please provide 2 independent referees (not relatives) in the boxes below:
1st Referee
Name*
Position*
Email*
Tel No*
Address*
2nd Referee
Name*
Position*
Email*
Tel No*
Address*
Marketing Feedback
How did you hear about the CELTA in Cambodia? Please provide details below:
I found the course …*
Writing Tasks
This section contains 2 writing tasks which include a Personal Statement and a Self-Assessment of your strengths and weaknesses. Please complete the tasks below:
a. In the box provided below, please outline why you want to do the CELTA and why you feel you would be a successful teacher of English to Speakers of Other Languages. (200 words at least)
Personal Statement*

Word Count: 0

b. Based on your current knowledge/understanding of the CELTA course, what would you expect your strengths and weaknesses would be while taking the course? (200 words at least)
Strengths & Weaknesses*

Word Count: 0

ACE Tutor Comments:
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