QUALITY SYSTEM DOCUMENT RG13

APPLICATION FORM CONVERSASPAIN Rev: P.

PUBLIC SCHOOLS 29/08 1 of 3

The aim of this form is to get to know you better. There are no correct or wrong answers. Providing false
information will result in expulsion from the program at any given point. All answers will be treated with strict
confidence.

PERSONAL DATA
Application
Full Name
Date
E-mail Gender Male Female

Contact Number SkypeID Facebook

Place of Birth Date of birth
(City & Country) Day/Month/Year
Degree and Subject GPA/Grade Year
Bachelor (B) Master (M)
Current address
City, State & Country

Please read carefully the FAQ’s before filling out this form to answer these questions correctly!

 How many consecutive days per week will you be teaching as an Auxiliar de conversación?
 How much is the monthly stipend in Madrid? And in Murcia?
 How much is the “Basic Fee” in Murcia? And in Madrid?
1. I have a passport from*:
*The Spanish Public Administration accepts applicants with passports from: Australia, Canada, Fiji, Malta,
New Zealand, the Republic of Ireland, Singapore, Solomon Islands, South Africa, Tonga, the United
Kingdom, the United States of America and Vanuatu.

Also applicants from the following countries may be accepted as long as they hold a C2 English Certificate
(CEFR) or equivalent: Belgium (only Madrid), Bulgaria (only Madrid), Denmark, Finland, Hong-Kong,
Hungary (only Madrid), India (only Murcia), Luxemburg (only Madrid), The Netherlands, Norway, The
Philippines, Russia (only Madrid), Singapore and Sweden.

C2 English certificate (if applicable): No Yes. Exam name and date:

2. Do you hold an EU passport? No Yes.

If you don’t, you will need to apply for a visa. Please, check here and let us know where your
corresponding consulate is. Country and city:

3. How did you get to know us?

4. When would you be available to start?

Jan. 2020

Oct. 2020

Nov. 2020

In compliance with the provisions of Data Protection regulations, we inform you that your personal data will be included in a file that MULTILINGUAL EDUCATION DEVELOPMENT
& SUPPORT SL (hereinafter ConversaSpain - with address at C / Benjamín de Tudela, 32 - 2 C, 31008 Pamplona and CIF: B71078950) has for program management purposes. If
selected, your personal data will be transferred to entities or professional collaborators that provide services for ConversaSpain, and may be transferred internationally in some
cases. We will store your data for four years. In any case, at any time, you have the right to access, rectify, limit, oppose or cancel the data referring to your person and included in
our file, directing your request to data@conversaspain.com. You can contact the corresponding local control authority if you consider that your personal data has not been handled
in accordance with current legislation. The data protection control authority in Spain is the Agencia Española de Protección de Datos.
 QUALITY SYSTEM DOCUMENT RG13
APPLICATION FORM CONVERSASPAIN Rev: P.
PUBLIC SCHOOLS 29/8 2 of 3

GETTING TO KNOW YOU

1. Where did you get your Degree?

Name of the University/College:

City/Country:

2. Do you hold a TEFL/TESOL certificate? No, I don’t Yes, I hold a

3. Please bear in mind that ConversaSpain is not in charge of the allocation process. Location preferences
cannot be guaranteed.

Region you would be interested in (more than one option is possible):

LOCATION
MADRID (Big city, suburbs or small-town locations)

MURCIA (Big city, suburbs or small-town locations)

Comments

4. Spanish level: None Basic Intermediate Advanced

5. If possible (this cannot be guaranteed), you would prefer to teach pupils aged:

3-12 (Infantil and Primaria) Over 12 (Secundaria) Flexible

6. Have you ever been an Auxiliar de Conversación in Spain before? No Yes

7. If you have been an Auxiliar de Conversación in Spain before, please include the following:
a) Name of the school: and location

b) Name of the school tutor/ bilingual coordinator:

c) Position:

d) Professional email:

8. Describe yourself in a few words (how do you see yourself as a person, hobbies, volunteer experiences…):

EXTRA INFORMATION
Disclaimer: We are aware that the following questions might entail sensitive information. We will treat this
information with the utmost care and it will be absolutely confidential. In order to speed up the approval
process and the required health insurance, we would need to know:

1. Are you taking any medicines/ are under any kind of treatment or have any health problems?

No Yes. Details:

For full information about Data Protection, please, refer to the first page of this document
 QUALITY SYSTEM DOCUMENT RG13
APPLICATION FORM CONVERSASPAIN Rev: P.
PUBLIC SCHOOLS 29/8 3 of 3

2. Have you ever been charged, arrested OR convicted for a criminal offence/ felony/ misdemeanor/ crime,
even if it was dismissed? No Yes. Please explain:

3. Do you take or smoke any drugs, even occasionally? No Yes. Comments

4. Are you applying with a friend/partner and wish to live in the same area? No Yes.

Name:

Although we cannot guarantee the placements will be in the same school, in case of married couples it is
taken into consideration in the allocation process.

5. Any other information you would like to add:

For full information about Data Protection, please, refer to the first page of this document