STUDY OF THE UNITED STATES INSTITUTE (SUSI) FOR SECONDARY

EDUCATORS 2017
APPLICATION FORM
Deadline to submit applications: December 30 before midnight. Please send to
the following e-mail address: USChileExchanges@state.gov
PERSONAL INFORMATION
A. Applicant's Full Name: Pamela Elizabeth Fernndez Neira
B. Gender: Femenine
C. Date of Birth: May 4th, 1979
D. City of Birth: Villarrica
E. Country of Birth: Chile
F. Country of Residence: Chile
G. Country of Citizenship: Chile
H. Medical, Physical, Dietary or other personal considerations (disabilities and
impairments): None
I. Contact Information:
Address:
Serrano con Linea Frrea 00 st.
City:
Los Alamos
e-mail: pamefern5@gmail.com
Phone: 41-2533255
Mobile phone: 984055036
Skype address:
In case of emergency, contact name and relationship:
Emergency contact phone: 962193220
Emergency contact e-mail: daniel1822@gmail.com
PROFESSIONAL INFORMATION
J. Current Position(s), Title(s) and Institution(s):
Current Positions
English Teacher

Institution
Liceo Caupolicn

Date

K. Work Experience, including Previous Positions, Titles, Institutions and Dates:

Previous positions and titles

Institution

Date
1

English Teacher
English Teacher

Liceo Caupolicn
Colegio Cristo
Redentor

March 1, 2004

L. Education, Academic and Professional Training, including degrees earned, year earned,
institution
and fields of specialization:
Training / Degree
English Teacher

Year
2004

Institution
Universidad de Concepcin

M. Additional Professional Training (if applicable):

N. Active Professional Memberships (Position, Title, Organization):
O. Short list of relevant Publications (no more than 5 to 10 citations), including
publication type, title, year of publication:
P. Previous Travel and Study or Research Experience in the United States, including
purpose, dates and indication of whether such travel was supported by U.S. Government
Funds.
Date

Purpose

Government Funds
Support

Q. Family and friends residing in the U.S. (Name, City, State):

Marjorie Mccue, Chicago
R. (Optional) Evidence of Fluency in Written or Oral English (TOEFL or IELTS or ETAPP Test
Scores; studies in English speaking countries):
TKT
S. Professional Responsibilities (Please discuss your professional responsibilities in
greater detail, including research interests, administrative responsibilities (e.g.,
curriculum design), and/or other pertinent information.
T. Current Courses Taught (course title, level of students, classroom hours per semester,
number of students)
2

Current course title

Level of students
1st to 4th grade
3rd to 4th grade

Classroom hours
per semester
3 hours per week
2 hours per week

Number of
students
276
52

High school
Electrician technical
students
Communicative
English
High school

3rd to 4th grade

2 hours per week

30

1 ciclo and 2
ciclo adult
education

4 hours per week

56

PERSONAL STATEMENT (Limit 250 words)

U. Please discuss how your interest in participating in the program and how your
participation would enhance your personal and professional goals.
Im a very active, motivated and creative teacher.
Ive been a teacher in the same high school for almost 13 years. Im very commited with
my workplace and community. I have had good results in my teaching process called
portofolio docente being Destacada twice. As an english teacher who lives in a small
town, it has being a little difficult to keep up on date with the language and practice it in
real life. Economics limitations has also being a problem. I want to teach my students
telling them how United States is in real life, and no just through the books we have to
read.
I have being an active member of the English network in my community, giving support
to my elementary colleagues and trespassing methological and teaching strategies. In
my high school