<p> TRAINING APPLICATION FORM</p><p>ACADEMIC YEAR 20…. - 20…. Period of Stay: From ...... / ...... / 20.... to ...... / ...... / 20....</p><p>HOME INSTITUTION DATA Home University: Faculty / Department: Coordinator name: Coordinator telephone: Coordinator e-mail:</p><p>STUDENT'S PERSONAL DATA Family name: First name(s): Birth Data: Gender: Male Female Postal address Current year at University degree Number of ECTS credits approved</p><p>FORMER PRACTICE EXPERIENCE Have you had practice experience before? Was it supervised by your University? In which field? For how long? Name of the practice institution and description if its main goals Describe the activities carried out during your practicum</p><p>FEATURES OF THE EXPECTED PRACTICES Number of hours per week Do you need to get ECTS credits with the practicum Do you need us to assess your practices? Does your university provide you with your own assessment document?</p><p>LANGUAGE FLUENCY Catalan language level Advance Intermedia Beginn Any d te er Do you have any language certificate in Catalan? Spanish language level Advance Intermedia Beginn Any d te er Do you have any language certificate in Spanish? English language level Advance Intermedia Beginn Any d te er Do you have any language certificate in English? Do you need to do your training in YES NO English Do you speak any other language? Which?</p><p>PRACTICE SELECTION</p><p>Choose three fields of practice, indicating order of preference (from 1 to 3): Allocation to the practice centre of choice will depend on availability of vacancies and command of the centre’s language</p><p>TEACHER TRAINING – EARLY CHILDHOOD EDUCATION Nursery School , 0-3-year-olds Early Childhood and Primary Education: Pre-School 3-6-year-olds</p><p>TEACHER TRAINING – PRIMARY EDUCATION</p><p>Early Childhood and Primary Education Centre - (6-12) Primary Speciality</p><p> a) General Class b) English Specialist Class SPEECH THERAPY (This option is only available for those students with a B.2 level of Spanish/Catalan) Special Education School Mainstream School CREDA (Resources Centres for Hearing Impaired People) Geriatric Homes CAP (Primary Health Care Centre) Hospitals: Acquired Language Disorders Private Offices: Developmental Language Disorders (Childhood) Private Offices: Voice and Communication (Adults) ORGANIZATIONAL PSYCHOLOGY (This option is only available for those students with a B.2 level of Spanish/Catalan) Human Resources Department in Companies Consultancies Professional Guidance Market Research</p><p>CLINICAL PSYCHOLOGY (This option is only available for those students with a B.2 level of Spanish/Catalan) Hospitals: Psychology and Psychiatry Hospitals: Acquired Disorders (Neuropsychology) Drug Addictions in CAS (Social Attention Centres) Mental Health Centres for Adults (CSMA) Mental Health Centres for Children and Youth (CSMIJ) Special Education and Disability Private Office Foundations and social projectes Geriatric Homes EDUCATIONAL PSYCHOLOGY (This option is only available for those students with a B.2 level of Spanish/Catalan) Regular School Private cabinet</p><p>PHYSICAL ACTIVITY AND SPORT SCIENCES (This option is only available during Spring Semester) Secondary Schools, Sports class (12-18 year students) Hospitals Foundations Fitness Centres and Associations Adventure Sports Companies Sports for People with Disabilities Sports Clubs</p><p>HOME INSTITUTION STUDENT Signature and stamp Signature</p><p>Name: Name: Date: Date:</p><p>HOST INSTITUTION (FPCEE-Blanquerna, Universitat Ramon Llull) Degree Coordinator name Description of the practices recommended Name of tutor recommended Name of practicum recommended Signature and stamp</p><p>Name: Date:</p>