English for Specific Purposes MOOC Camp

Application for Training

Deadline: January 30, 2017

Program Description: The Regional English Language Officer, U.S. Embassy, Islamabad is seeking
applications for a five-day professional development workshop, English for Specific Purposes MOOC
(Massive Open Online Course) Camp, which be held in Islamabad February 20-24, 2017.
NOTE: There is an expectation for all selected workshop participants to lead follow on activities for an
additional five months in communities with peers and/or students and report back.
Under this program, Ball State University will provide training for Pakistani educators on facilitating
MOOC study groups and integrating MOOC content into traditional classes, as well as on teaching
autonomous learning strategies to students to promote success in online learning environments. The
following five MOOCs will be highlighted:

English for Business and Development

English for Journalism
English for Career Development
English for Media Literacy
English for STEM Fields

The training in Islamabad will combine face-to-face training with online engagement to support educators
as they implement MOOC-related activities in their home institutions. Program travel and
accommodation (shared rooms; same gender) will be provided. All meals will also be provided.
Participants should demonstrate the following:

Strong and ongoing commitment to their professional development and learning new techniques.
Strong interest in developing appropriate and relevant content into their curriculum
Keen interest in sharing techniques and information gained from the workshop with their peers in
their local community
Strong leadership and communication skills, including the English language skills needed to
participate fully in the workshop

Eligibility requirements
In addition to the demonstrated skillsets listed above, applicants must meet the following requirements to
be considered for nomination:
Have oral skills equivalent to B1- C2 language proficiency as defined by the Common European
Framework of Reference of Languages.
Demonstrate commitment to share learned knowledge in his/her local context and;
Not have any existing health issues that may preclude them from traveling

Application Form
Fill in the application form in BLOCK letters and email to PakistanRELO@state.gov by
January 30, 2017.
Please send your ONE-PAGE brief curriculum vitae (C.V.) with this form.

General Information
First Name: ______________________ Middle Name: ________________ Last Name:
____________________
Prefix (Mr./Mrs./Ms.): ______________ Date of Birth (mm/dd/yyyy)___________ Gender:
________________
Home Address:
_______________________________________________________________________________
_________________________________________________ Nationality/ies:
____________________________
City / Province: __________________________________ Home Phone No. (Res.):
_______________________ Work Phone No. _________________________________

Cell No.

(Personal): ___________________________
Email Address:
________________________________________________________________________________
Alternate Email Address:
_______________________________________________________________________

Teaching Experience
Current Job Title:
______________________________________________________________________________
Name of Organization:
_________________________________________________________________________
Date joined (mm/dd/yyyy): ___________________________ Subject(s) you Teach:
_______________________

Level(s) you Teach:

____________________________________________________________________________
Please enclose your ONE-PAGE brief curriculum vitae (CV) with this form

Previous Teaching Experience (Past 5 years)

Job Title:
____________________________________________________________________________________
Name of Organization:
_________________________________________________________________________
Employment Period: from (mm/dd/yyyy)_______________ to (mm/dd/yyyy)
______________

Job Title:
____________________________________________________________________________________
Name of Organization:
_________________________________________________________________________
Employment Period: from (mm/dd/yyyy)_______________ to (mm/dd/yyyy)
______________

Job Title:
____________________________________________________________________________________
Name of Organization:
_________________________________________________________________________
Employment Period: from (mm/dd/yyyy)_______________ to (mm/dd/yyyy)
______________

Educational Background
Name of Institution

Course of Study

Date of Attendance
From:
To:

Additional Information
1.English Language Proficiency
Test: ___________________________________ Date: ________________ Score:
_______________________

OR
Self-assessment of Skills (using the CEFR self-assessment matrix
http://tinyurl.com/nrqsqtz)

A1

A2

B1

B2

C1

C2

Listening
Reading
Spoken
Interaction
Spoken
Production
Writing

2.Please assess your present computer literacy

Basic technology skills related to email, internet, searches, download/uploads,
logins/passwords
Excellent

Good

Fair

Poor
Practical application in listening and speaking skills Usage of Skype and other
real-time tools

Excellent

Good

Fair

Poor
Your ability to type in English on the computer
Excellent

Good

Fair

Poor
3a. Do you have regular (4-5 times per week) access to reliable internet
connectivity? ____________________
3b. How much time, on an average, do you spend online every day?
___________________________________
4. Which internet browser(s) do you use?
_________________________________________________________
5. Which Operating System do you use?
__________________________________________________________
6. Can you devote at least 10-12 hours per week to the online coursework?
Yes
No

PERSONAL ESSAY
7. Explain why you think you would be a good candidate for this MOOC Camp
training. Specifically, describe your local context and the educators you might
work with as part of the follow on activity. How many local educators do you
think would be interested in taking a MOOC and being part of a weekly
facilitated session? Where would you conduct the follow on activities? Does
this location have computers and internet connection? Describe. (No more than
300 words)

By my signature, I certify that, to the best of my knowledge, the information provided in

this application is accurate and complete and I am committed to the follow-on activity this
program requires of participants.

Name of Applicant:
___________________________________________________________________________

Applicants Signature ________________________________________________

__________________

Date: