International Teacher Placement Service
Important Note: The Asian Countries such as China, Taiwan and Japan only issue English teacher's visa to the following nationals: USA, Canada, UK, South Africa, New Zealand and Australia.
ITPS International Teach Placement Service
2222 Michelson Drive, Suite 5220 Irvine, California 92612 Telephone: (949) 892-8420
APPLICATION FOR Overseas Teaching Position
TO THE APPLICANT: These forms will complete your initial application for a teaching position overseas. Although this office does not guarantee the acceptance, we do encourage you to pray for God's leading and submit your application.
GENERAL INFORMATION:
First Preference - Country:
Second Preference - Country:
Full Name:
Date of Birth:
Age:
Place of Birth:
Citizenship:
SS Number
Gender:
Current Address:
City:
State:
Postal Zip Code:
E-Mail Address:
Home Phone:
Work Phone:
Passport Number (If available) :
Passport Expiration Date:
Marital Status:
Have you ever been convicted of a felony or misdemeanor?
Emergency Contact:
Relationship To You:
Emergency Contact H ome Phone:
Emergency Contact Work Phone:
Your Occupation:
School Attended (or graduated):
Education (Years):
College (Years):
Postgraduate (Years):
Major:
Special Skills:
Other Special Skills:
Specify Instrument If Music:
Financial Support: (besides salary)
Name of Church attending:
Email:
Pastor's Name:
Church Phone:
Church Address:
The names of your close friends also applying (if any):
REFERENCES:
Reference 1 - Name:
Years Known:
Address:
Phone:
Reference 2 - Name:
Reference 3 - Name:
HEALTH QUESTIONNAIRE:
Short-term missions can be exciting and inspiring; they can also be strenuous and stressful. There are many factors that can aggravate certain health conditions, and the medical facilities in some countries where we travel may not provide timely and adequate care. Your health and safety is our primary concern. If necessary, we may request a medical release from your doctor.
General Information - Height:
Weight:
Have you been in good health most of your life?
Have you had any serious illnesses?
If yes, please explain:
Allergies:
Medications:
All applicants must refrain from using any alcohol or tobacco while serving overseas.
HEALTH QUESTIONAIRE CHECKLIST
Respiratory :
Asthma or wheezing:
Difficulty breathing: