Department of Mathematics and Statistics
Student Assistant Application
Deadline for submission is 5pm on the second day of the semester. Please submit to the General Office,
HH 3003, or email to firstname.lastname@example.org .
Memorial University protects your privacy and maintains the confidentiality of your personal information. The information requested on
this form is collected under the authority of the Memorial University Act (RSNL 1990 Chapter M-7) and is required to process your
application for a student assistantship position. Upon acceptance for this position the information will form part of your departmental
personnel record and will be used for payroll purposes. If you have any questions concerning the collection and use of this
personal information, please contact the Department of Mathematics and Statistics at (709) 864-8784.
Surname: Given Names:
The place where your T-4 form should be sent.
Phone #: M.U.N. #:
Soc. Insur. #: E-mail Address:
Place of Birth:
Are you legally qualified to work in Canada?
Year in University: 2
In the semester in which you wish to be hired, you will be a student.
List Mathematics and Statistics course completed together with marks obtained.
Course Mark Course Mark Course Mark Course Mark Course Mark
I am applying for the position of Marker for the following courses in the semester.
1000 level preference(s):
2000 level preference(s):
3000 level and above preference(s):
Hours per week (per semester) I am willing to work.
3(30) 4(40) 5(50) 6(60) 7(70) 8(80)
I hereby certify that the information above is accurate.
Note: The performance of a student assistant is evaluated. Instructors expect assignments to be marked
quickly (3-4 days). An unsatisfactory performance normally means that you will not be hired in
STUDENTS: DO NOT WRITE IN THIS SPACE
Hired for: Course Number(s)
Hours to be Worked
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