Georgia College
Graduate Assistant Application—College of Education
Name:________________________________________________________________________________
Last First Middle
Social Security (or GCID) Number:________________________ Degree Sought:_____________
Major:_______________
Type of GA Position for which applying.
___ General (20 hrs/wk) ___ MAT (10 hrs/wk) ___ Early College (20 hrs/wk) ___Peace Corp (20 hrs/wk)
Permanent Address: Local Address: (if different from permanent)
_________________________________________ _________________________________________
_________________________________________ _________________________________________
For summer correspondence, check which address to use: ____permanent ____ local
Local Phone Number: (_____) ______________ E-mail Address:_________________________________
Currently Enrolled? ____ (Y) ____ (N) Term You Plan To Enter: _________________________
Colleges or Universities Dates Degree(s) Major Field
Attended Received of Study
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Work Experience: (Include research, teaching, tutoring, paper grading, industrial, farm
and military.) Please attach resume.
Dates Employer Nature of Work
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Special Skills: (Include computer experience)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I hereby certify that the facts set forth in this application for a graduate assistantship are true and complete to the best of
my knowledge. I understand that if I receive an assistantship, any falsified statement herein is considered sufficient
cause for dismissal. I understand that information concerning past employment, references, education and other facts
are subject to inquiry. I have read and understand the rules and regulations of an assistantship and the two-year time
limit (six consecutive semesters). I agree to abide by the regulations governing the assistantship program.
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Signature of Applicant Date
Mailing Address: College of Education, GC, Campus Box 070, Milledgeville, GA 31061
