Name: __________________________________________
Review of completed applications will begin May 4, 2015 and continue
until vacancies are filled. In order to receive full consideration, please
submit materials as soon as possible.
A completed file will contain the following: completed application,
resume, undergraduate transcript(s) and 3 completed reference letters.
Successful candidates must be fully matriculated in a graduate
program at SUNY Fredonia by the start of employment.
Submit applications to:
Dr. Christine Givner
Dean, College of Education
SUNY Fredonia, 705 Maytum Hall
280 Central Avenue
Fredonia, NY 1406
By: Friday, May 1, 2015
2
Graduate Assistant Application
Name: _______________________________________
ID#:___________________________
Current Address: _______________________________
Current Phone: __________________
_______________________________
Permanent Address:_____________________________
Permanent Phone:_________________
______________________________
Email:__________________________
Current citizenship status:
____U.S. Citizen
____ Permanent Resident
____ Not a U.S. Citizen
If not a U.S. Citizen, please identity type of Visa: _________________________________
Current Graduate Student Status at SUNY Fredonia:
____ Matriculated Student ____ Non-Matriculated Student
____ Neither
Indicated the date on which you will be available if offered an assistantship:
____ FALL 2015
____ SPRING 2016
SUNY Fredonia Graduate Study Information:
Have you held an Assistant position before? ______If yes, what type:_________________________
Supervisor:________________________________________
Type of tasks performed:______________________________________________________
Current Certificates and License: _____________________________________________________
Current Graduate G.P.A: ______________________ (approximate)
Graduate program to which you have applied: ___________________________________________
Date graduate application submitted:_____________ Expected date of graduation: ______________
3
References:
Please list the names and contact information for three individuals you will contact for references.
These individuals are each asked to submit a letter of recommendation to Dr. Christine Givner:
Name
Title
Address
Phone #
1.______________________________________________________________________________________
2.______________________________________________________________________________________
3.______________________________________________________________________________________
Education:
College/University
Date Attended
Major
Degree
GPA
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Employment Experience:
Position Title
Dates of
Employment
Employer
Employer
Address
Employer
Phone #
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Honors/Awards:__________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
4
Please answer these questions specifically and precisely. All responses must be word processed in a
separate document. Hand-written answers to the application questions will not be accepted.
1. Please list and describe any activities, work or supervisory experiences that have contributed to your
qualifications for a Graduate Assistant position.
2. In order to be successful as a Graduate Assistant you must be able to balance the demands of your
graduate study, this position, and your personal life. How do you handle competing demands of your
time?
3. Personal interaction, communication and informal leadership skills are necessary for successful
performance as a Graduate Assistant. Please describe your experiences and the personal strengths
you possess which have prepared you for these aspects of the position.
4. Please describe any experiences you have had in the following areas:
a. Teaching or serving as a teaching assistant, including responsibility for grading.
b. Community service.
c. Global or international endeavors.
d. Mentoring.
5. Have you lived in another country? If so, please indicate in which country(ies) you have lived, and
under what circumstances (e.g. Citizen, Peace Corps member, member of U.S. military, child of
military parent(s), academic exchange student, etc.).
6. Are you fluent in languages other than English? If so, please list the languages you speak.
The applicant’s signature below indicates an affirmation that all information provided in this application is
true to the best of your knowledge.
_______________________________________________
Applicant Signature
Submit your application to:
Dr. Christine Givner, Dean
College of Education
SUNY Fredonia, 705 Maytum Hall
280 Central Avenue
Fredonia, NY 14063
Fax: 716-673-3338
By: Friday, May 1, 2015
_______ ___________
Date