IH London Blended Cert ICT enrolment form

Full name *

Email address *

Postal address *

Phone number *

I am aged 18 years or over *
Yes
No

I hold a pre-service teaching qualification OR an in-service teaching qualification *
Yes
No

Please include details of your teaching qualifications, and the dates these qualifications were awarded: *

My level of competence in English is of a standard sufficient to enable me to fully understand and complete the course work. *
Yes
No

Is English your mother tongue? *
Yes
No

Details of English language qualifications held if English is not your mother tongue:

I am willing to work co-operatively as a member of a group, and to complete short pair and group work tasks online during the course. *
Yes
No

I will have access to real language learners, either a class or 1-1 students, and either f2f or online, to implement the final course project, during the final three weeks of the Cert ICT course. *
Yes
No

If you have any special needs, such as partial blindness, hearing-impairment, etc. please note these here:

Where did you hear about The Consultants-E Blended Cert ICT course? *