Fillable CCSU Graduate Assistantship Request Form

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CCSU Graduate Assistantship Request Form

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The CCSU Graduate Assistantship Request Form form is 2 pages long and contains:

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Graduate Assistantship Request Form
To request a Graduate Assistant position: Fill out this form completely and return it with appropriate
signatures to the Dean of Graduate Studies, Barnard Hall, Room 102. Deadlines for making a request are
July 1st
for the Fall semester; December 1
st
for the Spring semester.
Semester: Fall Spring Year:
Department/Area: __________________________________
School/Division: __________________________________
G.A. Supervisor: __________________________________
Campus Phone: __________________________________
Graduate Assistant’s Name (if known):
CCSU ID#: GPA:
Assignment Type:
Assist Faculty in Conducting Research (259099)
Assist Staff in Sports Related Duties (272099)
Coordination of Service/Community Activities (119199)
Laboratory Duties (251191)
*Assist Faculty in Teaching & Related Instructional Duties (251191)
*For a teaching assignment, please specify the following:
Course Name and Number (ex. PSY 235, ENG 110, etc.): __________________________________
Teaching Faculty Instructor: _____________________________________
Describe G.A. Duties and Responsibilities:
Please Note: Graduate Assistants MUST hold a 3.00 GPA at the time of the appointment.
Page 2
Provide Goals and Objectives for G.A.:
Evaluation procedures used to determine overall effectiveness of the G.A. and assignment:
Required Signatures:
Approved Not Approved
Department Chair/Division Head Date
Banner Funding Code:
Funding Source Designee Date
Approved Not Approved
Dean, School of Graduate Studies Date
Revised 8/2014
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CCSU Graduate Assistantship Request Form

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Completed 25 December 2019

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