Strategic Decisions and Partnerships

PROJECT OVERSEAS

*Please note that the application is divided into two sections A copy of Section A, containing information of a general nature and related to academic background and professional experience. Section B asks for information of a more personal nature and access to it will be restricted to the SDPUS selection committee, your team leader and to the staff of SDPUS’s international programs.

THE APPLICATION BELOW IS TO BE COMPLETED & RETURNED

1. All applicants must: ♦ hold an appropriate teachers’ certificate ♦ have at least 3 of verifiable teaching experience ♦ be in excellent health ♦ show evidence of flexibility and mature judgment

2. The commitment to Project Overseas is great both in and out of the classrooms.

3. Because of the nature of the Project, participants aren't allowed to be accompanied by friends or family during the orientation program or during the active program overseas.

4. Participants must be aware that a project may be cancelled at the last minute due to unforeseen circumstances. SDPUS can't guarantee placement on another team.

5. More affordable accommodations can often be implemented by sharing a living accommodation with other Project Overseas participants.

6. Project Overseas operates mainly in Costa Rica, but eventually opportunities will be available elsewhere in Latin America. Participants must be prepared to be assigned to any location in Costa Rica where there is a SDPUS Overseas Project.

7. Most Project Overseas assignments are 4-12 weeks long. SDPUS does not usually know program dates until February each year, after teams are formed, and it is important to note that some projects do span most of the summer (June, July & August) and dates are subject to change.

*Applicants must be flexible and available for the entire summer

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PLEASE RETURN THIS FORM TO SDPUS June 1^st To be considered for a FALL Nov.1^st To be considered for a SPRING April 1^st To be considered for a SUMMER

SECTION A PLEASE TYPE OR PRINT Name (First)_____________________________ (Last)_________________________ Male: 􀁔 Female: 􀁔 Name as it appears in passport:_____________________________________ Date of birth: ____________________________________________________ Home Address: _____________________________________________ Telephone: __________________________Fax: ______________________ E-Mail:__________________________________________________________ School or Work Address: ___________________________________________ Telephone: _____________________Fax:________________________ E-Mail:___________________________________________________________ Present Position: If retired, state month & year___________________________ School or Institution: ________________________________________________

Please complete the following: Date of last day of school at your present institution: ______________________ Date on which your school will open in the fall:____________________________ Latest date by which you must arrive home after the assignment: __________________________________________________________________ ACADEMIC BACKGROUND (Please list beginning with most recent) PLEASE COMPLETE THIS PAGE AND DO NOT SEND YOUR CURRICULUM VITAE/ RESUMÉ NAME AND LOCATION OF TEACHER TRAINING____________________________________ INSTITUTION, UNIVERSITY AND RECENT_________________________________________ SUMMER COURSE_____________________________________________________________ DATES DEGREE/CERTIFICATE RECEIVED:________________________________________ MAJOR AREA OF STUDY: _______________________________________________________ TEACHING BACKGROUND (Please list beginning with most recent) SCHOOL AND LOCATION_______________________________________________________ POSITION (e.g., Teacher, Principal, Dept. Head) _____________________________________ GRADES TAUGHT_____________________________________________________________ SUBJECTS TAUGHT___________________________________________________________ OTHER WORK EXPERIENCE (Do not list short-term or summer positions) JOB TITLE ___________________________________________________________________ DATE TEACHING CERTIFICATE WAS GRANTED ___________________________________ WHERE APPLICABLE___________________________________________________________ LOCATION____________________________________________________________________ LEVEL OF LINGUISTIC ABILITY ENGLISH SPANISH Poor Fair Good Excellent ← ORAL COMPREHENSION → Poor Fair Good Excellent Poor Fair Good Excellent ← WRITTEN COMPREHENSION → Poor Fair Good Excellent Poor Fair Good Excellent ← ORAL EXPRESSION → Poor Fair Good Excellent Poor Fair Good Excellent ← WRITTEN EXPRESSION → Poor Fair Good Excellent FIRST LANGUAGE: English􀁔 Spanish 􀁔 Other (Specify) __________________

LANGUAGE IN WHICH YOU COMPLETED YOUR STUDIES: Secondary Level: English􀁔 Spanish 􀁔 Other (Specify) __________________ University Level: English􀁔 Spanish 􀁔 Other (Specify) __________________

LANGUAGE IN WHICH YOU CAN COMFORTABLY TEACH English:􀁔 Spanish 􀁔

SUBJECT PREFERENCES Bearing in mind that you will be teaching unqualified or under-qualified teachers, content and methodology. What subjects and levels would you feel confident teaching, and in which language? ______________________________________ __________________________________________________________________

SUBJECT LEVEL: PRIMARY ELEMENTARY SECONDARY EXPERIENCE IN ORGANIZATIONS Outline your involvement in your teachers' organization :____________________ __________________________________________________________________

Other Organizations: ________________________________________________ __________________________________________________________________ DEVELOPMENT ASSISTANCE PROGRAMS a) Have you previously participated in SDPUS’s Project Overseas? Yes:􀁔 No:􀁔 In what country?_____________________________ Years:________________

Are you interested in being a team leader? Yes: 􀁔 No: 􀁔

b) Have you ever participated in cultural exchange programs designed to assist people? Yes: 􀁔 No: 􀁔 Overseas (specify countries, dates, and nature of program):________________ Dates of program:__________________________________________________ Nature of program:__________________________________________________ _________________________________________________________________

SECTION B PLEASE RESPOND BRIEFLY: a) Why do you wish to participate in Project Overseas?____________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ b) Why do you think you are well suited to such an assignment?____________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ c) What would you see as your responsibilities as a member of a Project Overseas team?____________________________________________________ _________________________________________________________________ _________________________________________________________ _________________________________________________________________ d) In your opinion, what are some of the challenges of working in a developing country?__________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ e) What do you think the objectives of educational aid in a developing country should be?________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ f) What do you see as the major hurdles facing education in a developing country? _________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ g) Please describe how you are currently pursuing your own professional development ______________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ RECREATION AND HOBBIES What are your hobbies and favorite forms of recreation? ___________________ _________________________________________________________________ _________________________________________________________ HEALTH How do you appraise your present health? Excellent: 􀁔 Good: 􀁔 Fair: 􀁔 If other than "excellent", please give details: ____________________________ _________________________________________________________________ _________________________________________________________________

Do you have any chronic ailments? Yes: 􀁔 No: 􀁔 Any physical disability? Yes: 􀁔 No: 􀁔 If yes, please specify: ______________________________________________ _________________________________________________________________

List any technical aids (wheelchair, etc.), or accessibility requirements (ramps, grab bars in wash rooms, etc.): _________________________________________________________________ _________________________________________________________________

List any serious illnesses you have had, giving dates:_____________________ _________________________________________________________________

List any allergies and/or dietary restrictions you have:_____________________ _________________________________________________________________

REFERENCES PLEASE PRINT OR TYPE Please provide the names and addresses of five persons whom further information may be obtained by the selection committee.

Principal or Superintendent:_______________________________________ Phone:______________________________ Email:_______________________________ Address:__________________________________________________________ *If retired, please submit most recent Principal or Superintendent _________________________________________________________________

Executive of Your Teacher Union: __________________________________ Phone:_____________________________ Email:______________________________ Address:__________________________________________________________

Professional Reference:____________________________________________ Job Title:__________________________________________________________ Phone:_____________________________ Email:______________________________ Address:__________________________________________________________

Professional Reference:____________________________________________ Job Title:__________________________________________________________ Phone:______________________________ Email:_______________________________ Address: __________________________________________________________

Personal Physician:________________________________________________ Phone:_______________________________ Email:________________________________ Address:___________________________________________________________

SCHOOL BOARD OR JURISDICTION Name of Present School Board or Jurisdiction_________________________ Address:___________________________________________________________ Telephone:_____________________________ Fax:__________________________________

Acknowledgement As a project overseas applicant, I understand and accept the following conditions: 1. I understand that every effort will be made to assign successful applicants in accordance with their skills and experience, but I am also aware that the nature of the requests from host countries may make this impossible. Yes:􀁔 No:􀁔 2. I am willing to accept an assignment to any Province in Costa Rica in which SDPUS organizes a cooperative project. Yes:􀁔 No:􀁔 3. I understand that PO is a collaborative team effort and participants are expected to share accommodations while on assignment overseas. Yes:􀁔 No:􀁔 4. I attest that I have taught for three full years. Yes:􀁔 No:􀁔 5. I acknowledge that have provided the personal information in this application form voluntarily to SDPUS for the purpose of applying as a participant in Project Overseas. Should I be accepted as a participant in Project Overseas, the personal information in this application form will be kept on file with SDPUS for the sole use of my involvement in Project Overseas. Yes:􀁔 No: 􀁔 Date: ____________________________________ Signature: _________________________________________

PLEASE COPY AND PASTE THE COMPLETED APPLICATION IN A MICROSOFT WORD ATTACHMENT AND SEND TO PFiorentino43@msn.com

YOU MAY ALSO PRINT AND COMPLETE THE APPLICATION AND THEN MAIL IT TO OUR ADDRESS BELOW

OR FAX THE COMPLETED APPLICATION FAX: 585 393-1408