DEPARTMENT OF NEUROBIOLOGY, PHYSIOLOGY &
BEHAVIOR
UNIVERSITY OF CALIFORNIA, DAVIS
1 SHIELDS AVENUE
DAVIS, CA 95616
APPLICATION FOR TEACHING ASSISTANTSHIP
ACADEMIC YEAR _______________
PLEASE PRINT OR TYPE. DO NOT USE PENCIL
NAME_____________________________ e-mail address________________________
Campus address______________________ Home address________________________
______________________
________________________
Campus phone_________________
Home phone_____________________
Phone where you can always be contacted (e.g., during summer) ___________________
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QUARTERS YOU WISH TO TEACH: FALL __ WINTER __ SPRING__ SUMMER__
Are you currently a registered graduate student at UC Davis?
Yes ___ No ___
If yes, in which graduate program are you enrolled? ______________________________
If no, have you applied to or been accepted by a graduate program at UC Davis?
Applied to: ______________________ Accepted by: ______________________
Degree sought:
MS (Plan I)_____
MS (Plan II)_____
Ph.D._____
Provide the name, address and phone number of two references.
1. Name __________________________ 2. Name ___________________________
Address ________________________
Address _________________________
________________________
_________________________
Phone __________________________
Phone ___________________________
Colleges or Universities Attended
Dates
Degree
Major
GPA
List below the physiology/neurobiology/other biology courses you have completed and
the grades received. For courses not taken at UC Davis, attach a brief description.
Course No. & Title
Institution
Grade
List below previous teaching experience, qualifications as a lab instructor, and any other
related employment experiences that might aid in evaluating your application.
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Indicate below the courses you feel qualified to TA.
Lab courses for which each TA position is 35-50% time:
CHA 101L
Gross Anatomy Lab
II
EXB 104L
Exercise Biology Lab
I, III
EXB 111
Envir. Effects on Physical Perf.
II
EXB 112
Clinical Exercise Physiology
II
EXB 115
Biomechanical Bases of Movement I
EXB 126
Tissue Mechanics
II
NPB 101L
Systemic Physiology
I, II, III, S.S
NPB 104L
Cellular Physiology/Neuro
II
NPB 111L
Adv. Systemic Physiology
I, III
NPB 124
Comparative Neuroanatomy
II
NPB 141;141P Phy. Adap. of Marine Org.; Lab
III
35% (10)
50% (9)
50% (2)
50% (5)
35% (1)
50% (1)
50% (34)
50% (2)
50% (7)
50% (1)
50% (1)
Lecture courses for which each TA position is 35-50% time:
BIS 10
General Biology
I, II
BIS 10V
General Biology (web virtual)
III
BIS 20Q
Modeling in Biology
I, II, III
EXB 101
Exercise Physiology
I
EXB 102
Motor Learn. & Sport Psych.
I, II
EXB 103
Intro to Human Movement
III
NPB 10
Elementary Human Physiology
II, S.S.
NPB 12
Human Nervous System
I
NPB 14
Illusions and the Brain
II
NPB 15
The Physiology of Human Aging
II
NPB 68
Intro to Biology of Addiction
III
NPB 100
Neurobiology
I, II, III, S.S.
NPB 100Q
Quantitative Found Neurobiology
III
NPB 101
Systemic Physiology
I, II, III, S.S.
NPB 102
Animal Behavior
II, III
NPB 112
Neuroscience
I
NPB 114
Gastrointestinal Physiology
I
NPB 152
Hormones and Behavior
III
NPB 168
Neurobiology of Addictive Drugs III
35% (2)
50% (4)
25% (3)
50% (1)
35% (2)
50% (1)
35% (2)
50% (1)
35% (1)
35% (1)
35% (1)
50% (8)
25% (1)
50% (5)
50% (2)
35% (1)
35% (1)
35% (1)
50% (1)
From those checked above, list (in order of preference) the courses you prefer to TA.
1. _______________
2. _______________
3. _______________
4. _______________
5. _______________
(I-FALL; II-WINTER; III-SPRING; S.S.-SUMMER)
Which courses will you not TA under any circumstances?
________________________
How many quarters of your program’s teaching requirement have you NOT yet
completed? (i.e., How many more quarters are you required to TA?)
0 _____
1 _____
2 _____
3_____
Not applicable _____
All international students must take UC Davis’ SPEAK test before they are
allowed to serve as a teaching assistant. Please indicate your status below.
_____ U.S. citizen
_____ Permanent resident
_____ International student
Country of citizenship _______________________
Date SPEAK test completed __________________
California resident status is established by an adult who has relinquished
prior residence and is physically present within the state for one year with
the intent to make California a permanent home. Other factors, however,
may affect residency status and you should consult the General Catalog for
more information.
Are you a California resident?
Yes _____
No _____
I certify that all the statements made in this application are true, complete
and accurate to the best of my knowledge and belief, and are made in good
faith.
_______________________________
Signature of Applicant
____________
Date
Please return to:
Department of Neurobiology, Physiology, & Behavior
One Shields Ave. - 188 Briggs
University of California, Davis
Davis, CA 95616
NOTE: Department affiliation is not a criterion for selection of teaching assistants.