UNIVERSITY OF LOUISVILLE
COLLEGE OF EDUCATION & HUMAN DEVELOPMENT
GRADUATE ASSISTANTSHIP APPLICATION
PLEASE TYPE OR WORD PROCESS (FORM AVAILABLE ELECTRONICALLY)
--
FULL NAME____________________________________________________________________________________
LAST
FIRST
ADDRESS___________________________________________________________
PHONE NUMBERS:
HOME (
ETHNICITY (Circle One)
CITY/STATE/ZIP__________________________________________
) _______________________________________
E-MAIL ADDRESS ___________________________________
African American
DATE______________________
OTHER
FEMALE______
Asian American
CELL (
MALE______
Hispanic
) ____________________________________
KENTUCKY RESIDENT ______YES________NO
Native American
White
Other__________________________
UNDERGRADUATE DEGREE __________
INSTITUTION______________________________ YEAR_________ MAJOR___________ MINOR__________
OTHER DEGREES EARNED____________
INSTITUTION______________________________ YEAR_________ MAJOR___________ MINOR__________
ACADEMIC STANDING:
CUMULATIVE UNDERGRADUATE GPA____________________
CUMULATIVE GRADUATE GPA___________________
CURRENT ENROLLMENT AT THE UNIVERSITY OF LOUISVILLE
_____YES______NO
UNDERGRADUATE_______ GRADUATE ___________
UofL STUDENT ID NUMBER__________________________
HAVE YOU EVER APPLIED AND BEEN ADMITTED TO UofL ____YES_____ NO
Check one of the following:
______GRE (Graduate Record Exam)
DATE_______________VERBAL___________
QUANTITATIVE_____________
ANALYTICAL__________
VERBAL + QUANTITATIVE_____________
______MAT (Miller Analogies Test)
DATE_______________SCORE_____________
YOUR GRADUATE PROGRAM OR PROGRAMS TO WHICH YOU ARE APPLYING___________________________________________________________
DEPARTMENT (Circle One)
ECEE
ECPY
ELFH
HPES
MISE
SPED
ADVISOR______________________________________
DEGREE (Circle One)
Ph.D
Ed.D
M.Ed
MA.
M.S.
M.A.
OTHER______________________________________
SEMESTER YOU BEGAN/WILL BEGIN THIS PROGRAM_________________ SEMESTER YOU WISH TO A BEGIN ASSISTANTSHIP_______________
SEMESTER YOU EXPECT TO COMPLETE YOUR DEGREE_______________
TOTAL GRADUATE HOURS EARNED TO DATE____________________
RELEVANT TEACHING, RESEARCH, BUSINESS, OR OTHER WORK EXPERIENCE
EMPLOYER
PLACE
DATES
JOB TITLE & DUTIES
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
SPECIAL QUALIFICATIONS AND EXPERIENCES WHICH MIGHT BE RELEVANT IN YOUR DUTIES AS A GRADUATE ASSISTANT
(FOR EXAMPLE, COMPUTER, RESEARCH, WRITING SKILLS, WORD PROCESSING, FOREIGN LANGUAGE, ETC.)
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
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GA APPLICATION SPRING 2015
COLLEGE HONORS AND OTHER EVIDENCE OF SCHOLARSHIP, INCLUDING ANY PREVIOUS SCHOLARSHIPS, FELLOWSHIPS OR ASSISTANTSHIPS
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
MEMBERSHIP IN COLLEGE ORGANIZATIONS AND/OR EXTRACURRICULAR ACTIVITIES IN WHICH YOU HAVE PARTICIPATED
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
PLEASE BRIEFLY STATE YOUR PROFESSIONAL GOALS:
DESCRIBE HOW YOUR EXPERIENCES AND SKILLS MATCH THE NEEDS OF UNIVERSITY FACULTY AND HOW AN ASSISTANTSHIP IN THIS
SETTING WOULD HELP YOU REACH YOUR PROFESSIONAL GOALS:
NAMES AND PHONE NUMBERS OF TWO PROFESSORS ACQUAINTED WITH YOUR WORK.
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
YOU MAY ATTACH A SEPARATE SHEET WITH ANY ADDITIONAL INFORMATION THAT YOU FEEL MAY ASSIST IN THE EVALUATION OF YOUR
APPLICATION. OFFICIAL TRANSCRIPTS AND GRE SCORES MUST BE ON FILE IN THE GRADUATE SCHOOL PRIOR TO CONSIDERATION. ANY
OFFER OF FINANCIAL AID IS CONTINGINT UPON UNCONDITIONAL ADMISSION TO THE GRADUATE SCHOOL.
RETURN THIS APPLICATION AND A CURRENT RESUME TO:
OFFICE OF THE DEAN
MELODY HALBLEIB
RESEARCH DEPARTMENT
COLLEGE OF EDUCATION & HUMAN DEVELOPMENT
UNIVERSITY OF LOUISVILLE
LOUISVILLE KY 40292
*
GA APPLICATION SPRING 2015