Sample application form

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TEXAS WOMAN’S UNIVERSITY
DEPARTMENT OF MATHEMATICS & COMPUTER SCIENCE
Course Assistant Application for
Fall 2015
Name: ________________________________________________________________
(Last Name)
Student ID#: ____________
(First Name)
Student email: _______________________________
Contact information
Permanent Mailing Address (home):
__________________________________________________________________________
(Number & Street)
__________________________________________________________________________
(City)
(State)
(Zip Code)
Local Address (School):
__________________________________________________________________________
(Number & Street)
__________________________________________________________________________
(City)
(State)
(Zip Code)
Phone # (including cell phone): _______________________________________________
Academic Background
Major: ______________________________________________(if Nursing, please also provide the
semester you will apply to Nursing School)
Minor:______________________________________________
Please complete the following table: Have you taken any of the following course or their equivalent?
Course
Equivalent Course
Completed?
Final Grade?
CHEM 1013
BACT 1003
MATH 1303
MATH 1703
Grade Level (circle one):
Freshman Sophomore Junior Senior Graduate Student
When do you anticipate graduating? ___________________
(month & year)
What is your GPA? _____________
Application 2/2015
Are you currently employed on Campus? Y/N; Off Campus? Y/N; How many hours? ________
Experience
Please briefly answer the following questions (Please attach additional pages if necessary):
Do you have teaching experience? If yes, give details ____________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Have you ever created lesson plans? If yes, for what class? _______________________________
_____________________________________________________________________________________________________________
Have you ever tutored any students? If yes, give details _________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Why are you interested in this position? ______________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
What contributions will you make to this program? _____________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
How will participating in this program support your goals? _______________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Recommendations should be emailed directly to [email protected] or sealed in an envelope with signature
across the seal by the Instructor and sent to Dr. Bev Carlsen-Landy, Math & Computer Science, MCL 412.
Application 2/2015
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