Graduate Assistantship Appointment Form
 This form may be initiated by the supervisor or department chair of the employing department,
but must also include the signatures of appropriate personnel from the college offering the
graduate program in which the student is enrolled, including the signature of the dean or his or
her designee.
o The supervisor, dean or his/her designee will explain the requirements for eligibility,
workload, and stipend payments.
o The employing department indicates the semester for which the assistantship is
applicable, the amount of the stipend, and the budget from which it is to be drawn.
o After obtaining all the required signatures, the dean or his/her designee will send the
form to the Graduate School Director.
 The Graduate School Director will review the request to ensure compliance with the policy and
obtain any required approvals from the Office of the Provost before forwarding to enrollment
services.
 Enrollment services personnel will verify eligibility of the student to enroll in a graduate
program and will assess tuition at the reduced rate and apply the mandated student insurance.
 The registrar will send the form to the human resources department so the student will be
hired as an employee and placed on the payroll for stipend payments.
All sections of this form are to be completed and filed with the appropriate departments by the end of the
early registration period for the semester the student is seeking approval.
Graduate Assistants must be fully admitted to a graduate degree, diploma, or certificate program in regular
status and enrolled in a minimum of nine (9) graduate semester hours for full waiver or minimum of six (6)
graduate semester hours for partial waiver for each term the assistantship is held. (Graduate assistantships
during the summer term will require enrollment for a minimum of six (6) graduate semester hours for a full
waiver.) For exceptions and a more complete statement of policies, see Graduate Assistantships Policy and
Procedures under Documents on the Graduate Council w
The Graduate Assistantship Appointment form may be completed for a two-semester period, and additionally for each
year or semester an assistantship is requested.
_________________________________________________________________________________________________
The following student has been granted approval for a graduate assistantship as stipulated.
Student’s Name _______________________________________________
Student ID Number __________________
Student Major Field of Study/Discipline: ________________________________________________________________
Employment Area: __________________________________________________________________________________
Duties:____________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Type of Graduate Assistantship (check one or more; see policy for definition):
Research (GRA) _____ Teaching/Instructor of record (GTA) _____ Teaching/Faculty Assistant (GFA) ______
Program (GPA) _____ Graduate Student Assistant (GSA) _____
Semester in which the Assistantship is to begin: ___________________ Year: _________
This assistantship is for the time period: ____________ 1 year _____________ (Note If a GA resigns or is terminated
prior to the end of this time period, a termination PAR must be submitted to Human Resources by the supervisor to
avoid overpayment.)
Amount of stipend/semester: ______________ Budget Account No: _______________________________________
Number of hours, the GA is expected to work: ______ (Approval of provost needed if <19)_______________________
Tuition Waiver: (check one if applicable)
Full Waiver - requires at least (19 work hours per week and fulltime graduate enrollment) ________
Partial Waiver - requires ≈ 10 work hours per week and at least part-time enrollment)
________
No tuition waiver. Tuition is paid by: (Check one and provide information, if applicable)
The student:
_________
Scholarship or Third Party:
_____________________________________________ (identify)
Department/Division:____________________________________________________ (identify)
If by Scholarship or Department/Division, Give Account No: ____________________________________
Signature of Graduate Assistant Supervisor _______________________________________ Date ___________
Signature of Chair/Director of Employing Department_______________________________ Date ___________
Signature of Graduate Director (Program or College) _______________________________ Date ___________
Signature of Academic Dean ___________________________________________________ Date ___________
_________________________________________________________________________________________________
I accept this graduate assistantship and understand the terms described above to include eligibility, reduction in tuition
rate and mandatory health insurance requirements.
Signature of Graduate Assistant ________________________________________________ Date ___________
_________________________________________________________________________________________________
The above student is eligible for enrollment in a graduate degree, certificate, or diploma program at Columbus State
University and (if tuition has been waived) has been assessed at the reduced rate for the term stipulated and mandatory
health insurance applied.
Signature of Graduate School Director ___________________________________________
Date ___________
Signature of Registrar or Designee ______________________________________________
Date ___________
Signature of Human Resources Director or Designee _______________________________
Date ___________
7-22-13