Indiana University Bloomington

 

Center for Chinese Language Pedagogy

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Application

2011 STARTALK Chinese Pedagogy Institute (CPI) Teacher Application Form

For problems with the application, please e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call (812) 856-0412.

THE PRIORITY DEADLINE TO APPLY FOR THE 2011 CHINESE PEDAGOGY INSTITUTE HAS NOW PASSED.  APPLICATIONS ARE NO LONGER BEING ACCEPTED.

Please note:  You will not be able to save an incomplete application form.  Please complete the form when you are ready to submit a complete application.


Personal Information
First Name
Middle Initial
Last Name
 Birth Date (mm/dd/yyyy)
/ /
Place of Birth
Native Language(s)
 
Gender:     Male Female
Citizenship
Are you a U.S. citizen? Yes No
If not a US citizen, are you a permanent resident of the U.S.? Yes No
Contact Information
Mailing Address

City
State
Zip
Home Phone
Work Phone
Cellular
Best time to be reached
Email address
Education

Graduate Credit: You will be eligible to receive 4-5 graduate credits for CPI at no cost to you (a $1,216 - $1,520 value). Would you like to register to take CPI for graduate credit?

Yes No

Higher Education Degree(s):
Degree
Major
Institution


Degree
Major
Institution


Degree
Major
Institution


Language Education Courses Completed
(for level, please specify undergraduate, graduate, or other)

Title
Level
Title
Level
Title
Level
Title
Level
Title
Level
Title
Level
Teaching Experience
Are you currently a practicing teacher? Yes No

If yes, please provide the following information:
Current School
City
State
Subject(s)
Grade Level
Are you currently certified to teach Chinese? Yes No
If yes, in which state(s) are you certified?
Level of certification (e.g., full, emergency, provisional, etc.)
If no, in what state are you seeking certification to teach Chinese?


Certification in Subjects other than Chinese

Subject
Grade Level
State
Subject
Grade Level
State
Subject
Grade Level
State
Subject
Grade Level
State


Language Teaching Experience

Language
School
Level
How long?
Language
School
Level
How long?
Language
School
Level
How long?
Language
School
Level
How long?


Non-Language Teaching Experience

Subject
School
Level
How long?
Subject
School
Level
How long?
Subject
School
Level
How long?
Language
School
Level
How long?


Language Proficiency:

Using the following language proficiency scale, indicate the number that most closely describes your proficiency (please select one for each category):

  1. no practical usable proficiency;
  2. able to read simple prose with difficulty, follow simple conversations, use the language to get around, but not as a means of exchanging ideas;
  3. able to read non-technical materials and technical writing in one's field, understand ordinary native speech, carry on an exchange of ideas though haltingly;
  4. fluency, accuracy, and range adequate for all normal social and professional situations;
  5. functionally equivalent to a well-educated native speaker; or
  6. native speaker;


Chinese:

Listening Speaking Reading Writing


English:

Listening Speaking Reading Writing


Indicate how Chinese proficiency, if any, was acquired (e.g., "two years undergrad study at Indiana University" ; "married to a Chinese person" ; "raised in a Chinese-speaking family").

Open-Ended Questions
  1. Please provide a one-page self-introduction according to the following guidelines.
    1. If you are a non-native speaker of Chinese, hand-write your self-introduction in Chinese and email it to This e-mail address is being protected from spambots. You need JavaScript enabled to view it . (If you are not able to scan it, fax it to 812.855.6402, "ATTN: CCLP".)
    2. If you are a native speaker of Chinese, write your self-introduction in English (word processing is acceptable) and email it to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
  2. Please write a statement in English no more than two double-spaced pages and email it to This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Your statement should describe the following:
    1. Previous teaching experience of Chinese language (if any)
    2. A concrete plan for attaining certification and how the Chinese Pedagogy Institute will help you achieve that goal (for non-certified teachers)
  3. What are the most important qualities of a Chinese language teacher? (list at least three)
  4. What challenges do you anticipate meeting in the institute and how will you address them? (examples include keeping up with a heavy homework load of English readings and working with a partner whose strong opinions differ greatly from your own)
Advanced Track Applicants

To apply for the advanced track, you must have at least 3 years of teaching experience and submit a Statement of Purpose detailing (1) why you consider yourself ready to take the important step from teacher to mentor, (2) the vision you have for yourself as a Chinese educator, (3) specific examples where you exercised initiative and leadership to improve and broaden the impact of the Chinese language program in which you work, and (4) steps you have taken during your career to improve your skills and professional status as a Chinese language educator. Email your Statement of Purpose to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Media Release

If accepted to participate in the Indiana University Chinese Pedagogy Institute, I hereby consent to being photographed by agents, employees, or representatives of Indiana University, the Language Flagship, and Startalk and to the use of photographs and videos in all forms of media for advertising, publicity, and other promotional purposes by Indiana University, the Language Flagship, and Startalk. I consent to the use of my name and the name of my school. I waive any right to inspect or approve the finished product, including written copy, wherein my photographs appear and waive all claims for compensation for such use or for damages.

I agree to the terms of this media release.

Commitment Pledge

If selected for the Chinese Pedagogy Institute, I agree to complete all institute requirements. As a sign of my commitment, I agree to pay a $250 deposit in addition to the non-refundable registration fee of $100. If I successfully complete the institute, I will be refunded this deposit of $250, which will otherwise be forfeited.

If I am not yet certified, I further agree to pursue certification in Chinese language teaching at the middle and/or high school level.

I agree to the terms of this commitment pledge.


Name

Important Notes
  1. Accepted applicants who are practicing Chinese teachers (at any level) will be required to send in a video clip of their teaching before the institute begins. The clip (at least 10 minutes in length) should show them accomplishing one instructional objective, such as teaching a grammar point or cultural concept.
  2. Accepted applicants will be required to bring a laptop computer to the institute with Chinese word-processing software already installed. Participants who do not own a laptop should borrow or rent one for the duration of the institute.
 


Contact

814 E 3rd Street
Indiana University, Bloomington, IN 47405
Map showing this location

Office: 812-856-0412, Fax: 812-855-6402

Email: cclp@indiana.edu