Program Application
Questions? Contact us: RELOMexico@state.gov
(55) 5080-2000 ext. 5269
Please send the completed application to
RELOMexico@state.gov
by Tuesday, October 13, 2020
The Winter term will run from January 12 to March 9, 2021
Participants will also have to complete a mandatory orientation module
between November 30 and December 30, 2020.
Instructions:
 You will needtohave MicrosoftOffice forthe form tohave full functionality.If youuse OpenOffice
or Google Docs,the formwill notworkcorrectly.
 Download the applicationformtoyourcomputer. Save it to yourhard diskwith your last names
before the current file name. Example:PerezMartinez 2020 OPEN Application Fall.doc
 Read the format carefullybefore fillingitout.Make sure to include all of the information required.
 To start fillingoutthe format,use the TABkey. You will onlybe able totype inthe shadedareas.
 To move fromone box to the next,use the TABkeyor the → ↑ arrow keys.Tomove back,press
SHIFT (mayúsculas) andTABat the same time or use the ← ↓ arrow keys.
 To check a box,clickon itor type X. To uncheckit,clickon it againor type X again.
 Shouldyouhave anyquestionsorneedhelptofill outthisform, please contactJosé Manuel
Villafuerte –WhatsApp5523009222.
General information
Full name as you wish it to appear on your certificate:
Country of residence:
State of residence: City of residence:
Are you a Mexican citizen? Yes No
Will you be living in Mexico during the OPEN course? Yes No
Primary E-mail:
Alternative E-mail:
Cell phone number (10 digits): This is also my WhatsApp number: Yes No
School/Institution you work at:
Program Application
Questions? Contact us: RELOMexico@state.gov
(55) 5080-2000 ext. 5269
What do you do? (Check all the boxes that apply.)
Soy profesor/instructor de inglés en (marque todas las que apliquen)
Educación básica (preescolar, primaria, secundaria) / media superior (prepa,
bachillerato, etc.) / educación superior (universidad o similar) / instituto de idiomas
Soy formador de profesores de inglés en un programa de licenciatura en una escuela
Normal o Universidad. Nombre del programa de licenciatura: Nombre de la Escuela
Normal o Facultad de la Universidad: . Imparto las materias siguientes: .
Doy capacitación a profesores de inglés (enlace/asesor técnico-pedagógicoosimilar) Título,
cargo o puesto: . Número de profesores que atiendo al año: . Número promedio
de talleres/sesiones que imparto al año: .
Superviso a profesores de inglés (coordinador, director, jefe de departmento, etc.). Título
oficial del puesto: . Número de profesores que superviso: .
Otro (especifique)
I am interestedintaking the following course: (Select up to three options with 1 being
your top choice.)
FosteringStudentMotivationandEngagement
Englishasa Mediumof Instruction
Content-BasedInstruction
IntegratingCritical ThinkingSkillsintothe Explorationof Culture inanEFL Setting
MethodologyforTESOL
Professional DevelopmentforTeacherTrainers
TeachingEnglishtoYoungLearners(under12 years old)
TeachingGrammar Communicatively
UsingEducational Technologyinthe EnglishLanguage Classroom
Program Application
Questions? Contact us: RELOMexico@state.gov
(55) 5080-2000 ext. 5269
Statement of Purpose: Please explain in English why you want to participate in the course
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?
MAXIMUM LENGTH: ABOUT HALF A PAGE. ADDITIONAL PAGES WILL NOT BE ACCEPTED.
Impact: How will you share the information you learn with your colleagues after the
completion of the course? (Check all the boxes that apply.)
Presentations Conventions
Workshops Distributing Material
Other (specify)
Language Proficiency:How good is your English? (Select the best option.)
Reading comprehension Excellent Good Fair
Expressing yourself in written English Excellent Good Fair
Computer Skills:Please evaluate your computer skills. (Select the best option.)
Excellent Good Fair None
Internet Access andTime Commitment:Please respond to the following questions.
I have regular and reliable access to high-speed internet connection. Yes No
I can commit to spending about 2 hours every day for the
duration of the 8-week course to complete it successfully. Yes No
I have taken an online course before. Yes No
Program Application
Questions? Contact us: RELOMexico@state.gov
(55) 5080-2000 ext. 5269
Previous scholarships:
Have you received an OPEN or E-Teacher scholarship before? Yes No
Have you taken an OPEN or E-Teacher MOOC before? Yes No

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2020 open application winter

  • 1. Program Application Questions? Contact us: RELOMexico@state.gov (55) 5080-2000 ext. 5269 Please send the completed application to RELOMexico@state.gov by Tuesday, October 13, 2020 The Winter term will run from January 12 to March 9, 2021 Participants will also have to complete a mandatory orientation module between November 30 and December 30, 2020. Instructions:  You will needtohave MicrosoftOffice forthe form tohave full functionality.If youuse OpenOffice or Google Docs,the formwill notworkcorrectly.  Download the applicationformtoyourcomputer. Save it to yourhard diskwith your last names before the current file name. Example:PerezMartinez 2020 OPEN Application Fall.doc  Read the format carefullybefore fillingitout.Make sure to include all of the information required.  To start fillingoutthe format,use the TABkey. You will onlybe able totype inthe shadedareas.  To move fromone box to the next,use the TABkeyor the → ↑ arrow keys.Tomove back,press SHIFT (mayúsculas) andTABat the same time or use the ← ↓ arrow keys.  To check a box,clickon itor type X. To uncheckit,clickon it againor type X again.  Shouldyouhave anyquestionsorneedhelptofill outthisform, please contactJosé Manuel Villafuerte –WhatsApp5523009222. General information Full name as you wish it to appear on your certificate: Country of residence: State of residence: City of residence: Are you a Mexican citizen? Yes No Will you be living in Mexico during the OPEN course? Yes No Primary E-mail: Alternative E-mail: Cell phone number (10 digits): This is also my WhatsApp number: Yes No School/Institution you work at:
  • 2. Program Application Questions? Contact us: RELOMexico@state.gov (55) 5080-2000 ext. 5269 What do you do? (Check all the boxes that apply.) Soy profesor/instructor de inglés en (marque todas las que apliquen) Educación básica (preescolar, primaria, secundaria) / media superior (prepa, bachillerato, etc.) / educación superior (universidad o similar) / instituto de idiomas Soy formador de profesores de inglés en un programa de licenciatura en una escuela Normal o Universidad. Nombre del programa de licenciatura: Nombre de la Escuela Normal o Facultad de la Universidad: . Imparto las materias siguientes: . Doy capacitación a profesores de inglés (enlace/asesor técnico-pedagógicoosimilar) Título, cargo o puesto: . Número de profesores que atiendo al año: . Número promedio de talleres/sesiones que imparto al año: . Superviso a profesores de inglés (coordinador, director, jefe de departmento, etc.). Título oficial del puesto: . Número de profesores que superviso: . Otro (especifique) I am interestedintaking the following course: (Select up to three options with 1 being your top choice.) FosteringStudentMotivationandEngagement Englishasa Mediumof Instruction Content-BasedInstruction IntegratingCritical ThinkingSkillsintothe Explorationof Culture inanEFL Setting MethodologyforTESOL Professional DevelopmentforTeacherTrainers TeachingEnglishtoYoungLearners(under12 years old) TeachingGrammar Communicatively UsingEducational Technologyinthe EnglishLanguage Classroom
  • 3. Program Application Questions? Contact us: RELOMexico@state.gov (55) 5080-2000 ext. 5269 Statement of Purpose: Please explain in English why you want to participate in the course 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? MAXIMUM LENGTH: ABOUT HALF A PAGE. ADDITIONAL PAGES WILL NOT BE ACCEPTED. Impact: How will you share the information you learn with your colleagues after the completion of the course? (Check all the boxes that apply.) Presentations Conventions Workshops Distributing Material Other (specify) Language Proficiency:How good is your English? (Select the best option.) Reading comprehension Excellent Good Fair Expressing yourself in written English Excellent Good Fair Computer Skills:Please evaluate your computer skills. (Select the best option.) Excellent Good Fair None Internet Access andTime Commitment:Please respond to the following questions. I have regular and reliable access to high-speed internet connection. Yes No I can commit to spending about 2 hours every day for the duration of the 8-week course to complete it successfully. Yes No I have taken an online course before. Yes No
  • 4. Program Application Questions? Contact us: RELOMexico@state.gov (55) 5080-2000 ext. 5269 Previous scholarships: Have you received an OPEN or E-Teacher scholarship before? Yes No Have you taken an OPEN or E-Teacher MOOC before? Yes No