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* 1. Funding for my participation is available

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* 2. Last name

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* 3. First name

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* 4. E-mail address

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* 5. Name of school, institution or organization

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* 6. Invoicing address - the name and address to which the invoice will be drawn and sent.  Please add any details e.g. project name and reference number required by your administration / authorities.  

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* 7. Subject or subjects you teach. If not applicable, please mark N.A. or provide further information.

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* 8. Age of your students. If not applicable, please mark N.A. or provide further information.

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* 9. Your experience in CLIL

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* 10. Please outline briefly how you support student diversity:

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* 11. Please state 1-3 things that you wish to gain from this course.

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* 12. Please specify any special requirements that you may have (e.g. dietary, allergies..)

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* 13. Any additional information that you may wish to give, or questions you wish to pose to the course team.

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