PsyF/QME TA Application Petition Form
Name:
Degree Program:
Date:
MA
PhD
Track/Area of emphasis:
Education History – please list:
College/Grad School Major/Minor Degree granted/pending & date
If you are applying for a 5-level course Graduate Instructor TA position and are petitioning for Master’s
equivalent, please attach the MA degree checklist and indicate the terms EPsy 5216 and 8216 were taken.
(Criteria for Graduate Instructor TAs are listed at the PsyF GA policies website.)
Please indicate the Job # and course you are applying for:
Please list the course(s) you have taken which you would like to have considered as equivalent to the course
you are applying for:
Please attach a copy of your transcript showing the petitioned equivalent course (with grade received), an
official course description and syllabus. Submit materials with job application.
To be completed by the Program:
I have reviewed the course(s) proposed as equivalent for the TA or Graduate Instructor position and find
that the student has acquired the knowledge and/or skills sufficient to be assigned as a TA for the course.
I have reviewed the course(s) proposed as equivalent for the TA or Graduate Instructor position and find
that the coursework is not sufficient to be assigned as a TA for the course.
Reviewer signature
Date