Teachers’ Application Form

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Name CPF RG Brazilian documents: (Mark all that you have) Carteira de Trabalho Carteira do MEC Título de Eleitor Cédula de Identidade Cédula do CPF Certificado de Reservista Cartão do PIS Address street complement borough city state ZIP code (numbers only) country Telephones Fixed Cell phone E-mail address Birthdate dd/mm/yyyy Place of Birth Gender Female Male Marital status single married   Do you have any children? yes no   If so, what age(s)?    In the case of an emergency, whom should we contact? (name, telephone number, relationship)   If you are a foreigner: Arrival date dd/mm/yyyy Port of Entry Passport #   Why are you in Brazil? Do you have a permanent Visa? yes no If not, what steps have you taken to get one?   If you are not a native English speaker:   Where did you learn English? Where have you lived (outside of Brazil)?   Educational history   Names, addresses, dates, and degree of schools that you have attended: University High School Special courses Certificates (Mark all that you have)   Others Name Year Name Year TOEFL  Cambridge  Michigan    Work history   Present job: Company name Position Contact Telephone Hire date dd/mm/yyyy Salary per month   Why do you want to leave your present job?   Previous job: Company name Position Contact Telephone Hire date dd/mm/yyyy Salary per month   Why did you leave your previous job?   Teaching history   Have you ever taught English before? yes no If so, where and for how long? Are you presently teaching English? yes no   Availability Where are you available to teach? (Mark all that apply) Barra da Tijuca Centro Ilha do Governador São Pedro d’Aldeia Zona Sul Other locations:         Do you have a car? yes no When are you available to teach?   Mornings Afternoons Evenings Monday Tuesday Wednesday Thursday Friday Saturday   If accepted, how long are you planning to teach at TAKE FIVE?   General   How did you learn about TAKE FIVE? Why do you wish to teach at TAKE FIVE? Please describe any other experiences, qualifications, professional goals, etc. that you have that might help us make our decision. Please list any other information that you think might be useful.