APPLICATION

Language Skill Improvement and Pedagogy Institute
Summer 2001, Middlebury College
Name (Please print Last, First, Middle Initial):
Address(street and number, city, state, zip):
 Telephone:
Home:
Office:
E-mail:
Best times to be contacted by phone:
Place:

Time:
Educational background (please send transcript(s) directly to the Institute office)


Institution                Dates attended        Major        Degree Year


Institution                Dates attended        Major        Degree Year
Study of Japanese


School or Program            Dates attended    Level studied      Average grade


School or Program            Dates attended    Level studied      Average grade


School or Program            Dates attended    Level studied      Average grade
Textbooks used:


Title                        Coverage


Title                        Coverage


Title                        Coverage
If available, results of any standardized Japanese proficiency test


Type of test                        Date taken               Result(grade or score)
Self-Assessment of Proficiency

How do you judge your proficiency in Japanese? For each of the following tasks, circle the appropriate number.
  1. Cannot perform the task at all.
  2. Can perform the task, but with a lot of difficulty.
  3. Can perform the task, but with some difficulty.
  4. Can perform the task with little difficulty.
  5. Can perform the task with no difficulty.
SPEAKING:
  1. Use minimum courtesy expressions (greetings, simple self-introduction)
    1        2        3        4        5
  2. Talk about your daily schedule
    1        2        3        4        5
  3. Handle everyday situations including travel(e.g., shopping, ordering food, making a hotel reservation)
    1        2        3        4        5
  4. Give simple autobiographical information(e.g., when and where you were born, your educational history)
    1        2        3        4        5
  5. Talk about past events and future plans(e.g., what you did last week, what you plan to do next summer)
    1        2        3        4        5
  6. Describe your family and house; things and places(e.g., your car, its color and shape, features; your town, size, industry, brief history)
    1        2        3        4        5
  7. Handle routine social demands(e.g., renting a house, talking with a doctor, asking someone to repair the toilet
    1        2        3        4        5
  8. Summarize a book you read or a movie you saw
    1        2        3        4        5
  9. Explain concrete matters(e.g., your states educational system)
    1        2        3        4        5
  10. Talk about current events(e.g., election 2000, Olympic games)
    1        2        3        4        5
  11. Talk about subjects relating to your field(e.g., how you write a lesson plan)
    1        2        3        4        5
  12. Express your opinion(e.g., on social or political topics)
    1        2        3        4        5
  13. Talk about subjects outside your field or unfamiliar topics
    1        2        3        4        5
  14. Handle business negotiations, argumentation, persuation
    1        2        3        4        5
LISTENING COMPREHENSION OF:
  1. Short, learned utterances pronounced slowly and clearly
    1        2        3        4        5
  2. Some sentence-length utterances in familiar contexts
    1        2        3        4        5
  3. Spontaneous face-to-face conversations; repitition and rewording may be necessary; topics are limited to learned items
    1        2        3        4        5
  4. Long stretches of connected discourse on a number of topics
    1        2        3        4        5
  5. Main ideas and most details of connected discourse on a variety of topics beyond the immediacy of the situation
    1        2        3        4        5
  6. Main ideas of most speech in a standard dialect unless that speech is highly linguistically complex
    1        2        3        4        5
  7. Main ideas of all speech in a standard dialect, including technical discussions in a field of specialization
    1        2        3        4        5
  8. All forms and styles of speech pertinent to personal, social, and professional needs tailored to different audiences
    1        2        3        4        5
READING:
I can recognize approximately_______Chinese characters
With regard to each of the following reading materials, circle the appropriate number.
  1. Cannot read at all.
  2. Can read, but with a lot of difficulty.
  3. Can read, but with some difficulty. Have to use dictionary a lot
  4. Can read with very little difficulty. Still have to use dictionaries.
  5. Can read with no difficulty. Hardly use dictionaries.

  1. Textbook-type simple, contrived texts
    1        2        3        4        5
  2. Menus timetables, and simple lists
    1        2        3        4        5
  3. Simple narratives of daily routines; simple descriptions of people, places, and things
    1        2        3        4        5
  4. Personal letters
    1        2        3        4        5
  5. Simple texts relating to your professional and academic subjects(e.g., abstracts of papers)
    1        2        3        4        5
  6. Essays on routine social matters
    1        2        3        4        5
  7. Newspaper and magazine articles
    1        2        3        4        5
  8. Manuals
    1        2        3        4        5
  9. Complex texts relating to your professional and academic subjects (e.g., research papers, books)
    1        2        3        4        5
  10. Prose materials on unfamiliar topics
    1        2        3        4        5
WRITING:
I can write approximately______Chinese characters
Rate your current writing ability according to the following list of scaled items.
My current writing ability corresponds approximately to no.___
  1. Hiragana and katakana letters
    1        2        3        4        5
  2. Learned words and phrases
    1        2        3        4        5
  3. Information on simple forms and documents
    1        2        3        4        5
  4. Short messages, postcards, and simple notes
    1        2        3        4        5
  5. Short, simple letters whose contents involve personal topics
    1        2        3        4        5
  6. Notes in some detail on familiar topics; summaries of your biographical data, work, and school experience
    1        2        3        4        5
  7. Cohesive narratives and descriptions of a factual nature
    1        2        3        4        5
  8. Social and informal business correspondence
    1        2        3        4        5
  9. Concrete aspects of topics relating to professional and academic specialization; written discourse supporting a point of view clearly and logically
    1        2        3        4        5
  10. Can articulate effectively in most formal and informal writing on practical, social, and professional topics
    1        2        3        4        5
Experience in Japan
Purpose:




Dates, length, and place(s) of stay:




Teacher certification


Subject                                State        Date certified        Valid until



Subject                                State        Date certified        Valid until
Teaching experience




School        Address            Subject taught        Grade taught        Dates




School        Address            Subject taught        Grade taught        Dates
Current teaching position
Describe your school setting (e.g., public / private; urban / suburban / rural; special features like AP, IB; diversity of student population; size of student body; number and levels of Japanese classes)










Describe your current Japanese language program (number of teachers, class size, levels of instruction, number of days and hours classes meet per week)










Instructional materials in use










Goals and expectations of the Japanese language courses you are teaching










Recommendations/Transcripts

Please request three letters of recommendation: one from your instructor of Japanese or someone who can comment on your Japanese skills; one from a department chair or teaching colleague; and one from a parent, student, or community member who has knowledge of your program. Submit transcripts from both undergraduate and graduate programs you have attended. Letters of recommendation and transcripts must be sent directly to the Institute Office (see address below). If selected to participate, you will be required to submit a letter of endorsement of your participation in the project from your Principal.
Were you a participant in the ATJ-sponsored Summer Fellows Program (1995-1998)?

        Yes_______        No______
Have you attended workshops or institutes on teaching Japanese that lasted longer than 4 or 5 days?

        Yes_______        No______
Other professional developement programs you have attended:




        Program                        Place                        Date




        Program                        Place                        Date
Essays
1) Please include in your application a 200-word essay describing [a] the strengths of your program and areas in which you wish to improve (e.g., instructional practice, classroom methods, materials development, assessment, technology, program advocacy), [b] what you expect to gain from participation in the Institute, and [c] how you plan to share the experience with your students or colleagues.
2) Also, on a separate page please describe your (non-teaching) professional activities, such as participation in professional organizations and community outreach.
Submitted by:


__________________________________________________________________
(Signature)                                                                    (Date)
Mail completed application to:
Language Skill Improvement & Pedagogy Institute
Alliance of Associations of Teachers of Japanese
CB 279, Humanities 240
University of Colorado
Boulder, CO 80309-0279