Request for ACTDEC Applicant Membership

To The Administrative Officer
and Council of ACTDEC.

Fill in the form below and please answer the questions.

Institution

Name of Institution
Website address

Postal address of institution

Line 1
Line 2
Line 3
Country
Post/Zip code

Person completing this form

First name(s)
Family name
Position in organisation

Contact

Phone number
Fax number
E-mail address

Institution's owner(s), partners, directors or (if applicable) department and name of contact person.

Owner
Partner(s)
Partner(s)
Director(s)
Director(s)
Contact person*

*Someone accountable within the company

On behalf of the above named institution, I hereby apply for Applicant Membership of ACTDEC for an initial twelve-month period from:

from
to

Under separate cover I am posting an applicant membership subscription cheque/draft for sterling £95 made payable to ACTDEC and addressed to the ACTDEC Treasurer to cover the period from the date indicated on this application to course accreditation which I/we understand must be achieved within a twelve-month period.

PLEASE USE THE RELEVANT BUTTON ON THE NEXT PAGE TO PAY WITH WORLDPAY

I confirm that this institution runs distance education courses leading to qualifications in teaching English to speakers of other languages.

Brief course details are set out on the following course description sheet. This information will be used to prepare a listing for the ACTDEC applicant membership list.

I understand that this request for Applicant Membership of ACTDEC will be considered by the membership committee of the Council.

If this application is accepted, I/we undertake to abide by the ACTDEC Code of Practice and, as soon as possible, to apply for Accreditation in the case of each TESOL distance-training course currently offered.

Course description

Name of Institution
Present Title of Course
Nearest ACTDEC framework level
Entrance Requirements and Typical Trainee



Duration [in study hours*] and Frequency of Course
Average Number of Participants
Present Resulting Qualification(s)
Validating Body
Other Relevant Information

* Monitored student study hours, i.e. time taken to complete self-assessed assignments and tutor-assessed assignments throughout the course.

Please check all relevant boxes have been filled in and click 'send'