Application Form

Please be advised that only selected applicants will be contacted for phone interview
Should you have any further inquiries, please email relobangkok@state.gov

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* 1. What is your name?

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* 2. Where do you live and teach?

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* 3. Are you a Thai citizen?

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* 4. Your Contact Information

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* 5. What do you do?

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* 6. Which AE E-Teacher Courses do you want to take? (Rank your top 3 choices 1 – 3 )

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* 7. Statement of Purpose: Please explain your reasons for wanting to participate in the courses you selected. What impact will your participation in this program have on your institution, or region, and how do you expect to use the knowledge acquired in this course? (150 words only)

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* 8. How will you share the information you will learn with your colleagues after the completion of the course? (Check as many boxes as apply)

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* 9. Please assess your present English language proficiency and computer skills. (select one)

  Excellent Good Fair
Understanding of written English
Expressing yourself in written English
Computer Skills

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* 10. Please respond to the following questions by selecting one of the boxes.

  Yes No
I have taken an online course before
I have regular and reliable access to high-speed internet connection
I commit to spending 10 to 12 hours online each week for the duration of the 8-week course to participate in this course

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