Teach in Brazil Application

GENERAL INFORMATION

First name: Street address:

Middle name: City:
Last name : State/Province:
Nickname: Zip/Postal Code:
Maiden name: Country:
Address valid until (mo/dd/yr):

E-mail: Birth date (mo/dd/yr):

Phone(home): Gender:
Phone (work) : Dates of availability:
Phone (cell): Permanent Address:
Emergency Contact (name & Permanent City / State / Zip /
number): Country:

TEACHING INTEREST

The International School of Carpina integrates English into

the core subject areas in the Reach for English workshops.

Preferred Subject Area (Math, Science, Art, etc.):

Secondary Subject Area:

EDUCATION AND EXPERIENCE

What year did you complete high school?

College, university, seminary or technical schools:
Degree/certificate: Graduation year:
Present Occupation:
Relevant teaching job experience, skills and/or hobbies:

How much formal and/or informal ESL/EFL or education

training have you had? Please describe.

Please list the names and contact information of two (non-

family) work/education references.

(1) Please send a recent resume, (2) and two (non-

family) letters of reference.
CHRISTIAN LIFE

Of what church are you a member?

Church name: Name of Pastor:

Phone: E-mail:
Full address: Frequency Attended:

Secondary Church (if you are affiliated with more than one
church)

Church name: Name of Pastor:

Phone: E-mail:
Full address: Frequency Attended:

May we contact your pastor(s)?

Have you talked with your pastor or church leadership about
your interest in Teach in Brazil?

Describe your involvement in Christian work.

Describe how and when you came to know Jesus Christ as

Savior.

Describe three ways that you can see God working in your life
now.

FAMILY

What is your marital status? Name of spouse, fiancé, or

fiancée:
Wedding date: Do you have dependent
children?
(list ages and genders)

Will you spouse be coming Will your children be coming

with you? with you?
Have you ever been Have you ever been
divorced? separated?

If you answered yes to either of these, please explain the

circumstances

FINANCES

Each teacher must look to the Lord to provide for all of his or
her financial needs through churches and friends. You will
need to raise support for your expenses while in Brazil (See
Costs section of the Brazil Info Packet).

Do you believe God can meet your needs in this way?

I attest and affirm that the information in this application is

true, correct and complete to the best of my knowledge:

Initialed (if filling out to be sent by email) or Signed:

Date: