Computer Science & Engineering University of Connecticut TEACHING ASSISTANTSHIP APPLICATION Please complete the following application and return it to the CSE office by November 15th for Spring semester and May 1st for Fall semester if you want to be considered for a teaching/grading assistant position. Name: _____________________________ Social Security No.: __________ Expected Date of Graduation________ Home Address: ___________________________________________________________________________________ Home Phone #: _______________________ Email Address: _____________________________________________ Currently working toward: ____MS ____Ph.D in CSE Current Status: ____Regular ____Provisional If not a U.S. citizen state visa status (including expiration date): __________________________________________ Note: Visa and working papers must be valid through January 6th for Fall semester and May 22nd for Spring semester Highest degree currently held: _________. Major: ____________________. Institution: ________________________ Note: It is your responsibility to meet the University’s English Speaking requirement before your appointment. All appointments are contingent on meeting those requirements. Refer to http://goo.gl/0eDyAg for a detailed discussion. Indicate how you meet the English Speaking Requirement by checking the appropriate column below. Native Speaker 27 ≤ TOEFL IBT 23 < TOEFL IBT < 27 [Score ______] Passed Microteaching Failed Microteaching TOEF IBT ≤ 23 List all courses for which you have assisted. Specify semester, indicate TA or Grader, and self-assess (A to D scale). Semester and Year Course Number TA Grader Self-Assessment (A-D) Office Use (Instructor) Choose the type(s) of aid you desire. Note that full-time teaching assignment may involve two courses. _____Full TA _____Half TA _____Grader Other (please specify)_____________________ Check any courses you are able to TA. Please note that lab courses may require lecturing to students during labs. Lab Courses CSE1010 CSE1102 CSE1729 CSE2102 CSE2300W CSE2304 CSE3666 Applicant Office Use Only Lecture Courses CSE2100 CSE2500 CSE3000 CSE3300 CSE3502 CSE3504 CSE4100 CSE4102 CSE4300 CSE4302 Applicant Office Use Only Advisor’s Endorsement Major Advisor Name: ____________________________ Research Advisor (if different): _______________________________ Major Advisor Signature: ________________________ Research Advisor Signature: __________________________________ 1