Petition for Appointment of an Associate Instructor (AI)
Approval must be obtained from the Committee on Courses of Instruction before the appointment of AI’s for upper division courses. To avoid delays
in approval, the following guidelines should be met.
Associate Instructor Name:
(Please Print)
Hiring Department:
Department Contact:
(Name)
(Phone #)
(E-mail address)
Request to serve as AI for course:
for Qtr/Yr: _________
(# & title)
Faculty Mentor for the course:
Appointment criteria:
Yes
 Has this individual passed to candidacy for the Ph.D?
 Does this individual have at least 3 quarters of teaching experience?
 Is this the only AI appointment for this individual in the current academic year (July – June)?
The Following are attached:
 Evaluations: Summary of Student Evaluations
 Curriculum Vitae (CV)
* A negative response to any of the above statements requires explanation. Please attach
this information, if necessary.
Signatures:
Hiring Department Chair:
Date:
Student Major Advisor:
Date:
Faculty Mentor for Course:
Date:
For Academic Senate Committee on Courses of Instruction Only
Date petition received:
Committee Chair:
Approved
Denied
Date Dept Notified:
Date:
No*