KEY STAGE 2 CHINESE LANGUAGE AND
CULTURE IMMERSION COURSES
APPLICATION FORM
Please read the application guidelines carefully before completing this form
COORDINATOR INFORMATION
This section should be completed by the person responsible for coordinating the application and all
administrative duties beyond the application stage. This person can represent the local authority
or one of the schools within the cluster submitting an application.
Name of Local
Authority:
Coordinator full name:
Coordinator job title
(within LA/School):
Name of School (if
applicable):
Co-ordinator’s contact
details (email address
and telephone
number):
CLUSTER INFORMATION
SCHOOL 1 INFORMATION
Name of school:
Address of school:
Name & job title of contact
person at school:
Email address & telephone
number of contact person:
The British Council would like to send you details of British Council activities, services and events,
which may be of interest to you. If you would prefer not to receive this information from us please
tick this box.
I do not wish to receive further information from the British Council:
Please answer the following questions concisely, using bullet points.
Has your school taken part in this course previously? (If yes, please state year and course
location)
Is Mandarin Chinese taught at any of the secondary schools to which your school feeds?
Outline the teaching of Chinese language and culture that already exists within your school.
How would involvement in the course be used as a springboard in your school for the future
teaching of Chinese language and culture?
Declaration (to be completed by the Head teacher)
I have read the course description in the application guidelines and understand that students
participating in the course must have sufficient maturity to spend a week away from home and fully
participate in an intensive, fast-paced language and culture course. I am very confident that,
should our cluster’s application be successful, our school would have 3-5 (depending on number of
schools in cluster) Year 5 students who would be very keen and able to take part.
I confirm my support, should our application be successful, to introducing/increasing the teaching
of Chinese language and culture in my school after the course, and to supporting local school in
doing so as well.
Signature
Date
(Please type your name above)
Name
SCHOOL 2 INFORMATION
Name of school:
Address of school:
Name & job title of contact
person at school:
Email address & telephone
number of contact person:
The British Council would like to send you details of British Council activities, services and events,
which may be of interest to you. If you would prefer not to receive this information from us please
tick this box.
I do not wish to receive further information from the British Council:
Please answer the following questions concisely, using bullet points.
Has your school taken part in this course previously? (If yes, please state year and course
location)
Is Mandarin Chinese taught at any of the secondary schools to which your school feeds?
Please outline what teaching of Chinese language and culture there is already within your school.
How would involvement in the course be used as a springboard in your school for the future
teaching of Chinese language and culture?
Declaration (to be completed by the Head teacher)
I have read the course description in the application guidelines and understand that students
participating in the course must have sufficient maturity to spend a week away from home and fully
participate in an intensive, fast-paced language and culture course. I am very confident that,
should our cluster’s application be successful, our school would have 3-5 (depending on number of
schools in cluster) Year 5 students who would be very keen and able to take part.
I confirm my support, should our application be successful, to introducing/increasing the teaching
of Chinese language and culture in my school after the course, and to supporting other local
schools in doing so as well.
Signature
Date
(Please type your name above)
Name
SCHOOL 3 INFORMATION
Only to be completed if there are 3 schools in the cluster.
Name of school:
Address of school:
Name & job title of contact
person at school:
Email address & telephone
number of contact person:
The British Council would like to send you details of British Council activities, services and events,
which may be of interest to you. If you would prefer not to receive this information from us please
tick this box.
I do not wish to receive further information from the British Council:
Please answer the following questions concisely, using bullet points.
Has your school taken part in this course previously? (If yes, please state year and course
location)
Is Mandarin Chinese taught at any of the secondary schools to which your school feeds?
Please outline what teaching of Chinese language and culture there is already within your school.
How would involvement in the course be used as a springboard in your school for the future
teaching of Chinese language and culture?
Declaration (to be completed by the Head teacher)
I have read the course description in the application guidelines and understand that students
participating in the course must have sufficient maturity to spend a week away from home and fully
participate in an intensive, fast-paced language and culture course. I am very confident that,
should our cluster’s application be successful, our school would have 3-5 (depending on number of
schools in cluster) Year 5 students who would be very keen and able to take part.
I confirm my support, should our application be successful, to introducing/increasing the teaching
of Chinese language and culture in my school after the course, and to supporting other local
schools in doing so as well.
Signature
Date
(Please type your name above)
Name
SUPPORT TEACHER INFORMATION
Please provide details below about the support teacher who will accompany the students to the
immersion course centre. The nominated support teacher should also be a key contact at one of
the schools within the cluster. For more information about the role of the support teacher during the
immersion course please contact us via the email address below. All teachers accompanying
student to the immersion courses must have a clear Disclosure and Barring Service check
(DBS) / Criminal Records Bureau (CRB) within the last 3 years.
Support Teacher Name
School
Yes/No
Trained in First Aid?
Please provide details of experience accompanying school residential trips:
Preferred course
location
Frensham / Oakham (please delete as appropriate)
Clear CRB/DBS within
last 3 years
Yes/No (please delete as appropriate)
If not, will have a clear
CRB/DBS by June
2016
Yes/No (please delete as appropriate)
Marketing and Promotion
1.) How did you hear about the Programme?
Promotional Flyer
Word of mouth
China Education Pack
Schools Online
Other
Would you be happy for some of your comments to be used in our promotional material and/ or
website if applicable?
Yes
No
Please submit applications by Friday 12 February 2016 via email to
HSBC_immersion@britishcouncil.org
Clusters will be notified of the outcome of their application by email no later than mid-March 2015.
HSBC China Team, British Council
Data Protection notice
Your personal information will be used in line with British Council standards. The British Council
will treat all personal information in accordance with UK law and its own privacy policy. The British
Council will not sell or disclose your details to third parties for commercial reasons.
Under UK Data Protection law you have the right to ask for a copy of the information we hold on
you, for which we may charge a fee, and the right to ask us to correct any inaccuracies in that
information. If you want more information about this please contact your local British Council office
or the Data Protection Team dataprotection@britishcouncil.org, or see our website:
http://www.britishcouncil.org/home-data-protection.htm.