PERSONAL INFORMATION
Last Name First Name UID#
RIT Email Alternated Email
Local Address
Male Female
Cell Phone Country of Citizenship
ACADEMIC INFORMATION
Class Status Grad Ph.D.
Major (Please list complete name): College Please select CAST CIAS COB COLA COS GCCIS KGCOE NTID Your current GPA:
GENERAL INFORMATION
Have you ever been involved in a college judicial action? Yes No If yes, please explain the situation and any sanction imposed:
Do you use Interpreting Services? Yes No
Will you be applying for a co-op in 2123? Yes No
Will you be applying for a co-op in 2124? Yes No
Will you be staying in Rochester, NY during the summer quarter? Yes No
As GA, you are required to attend PAL training August 15th and 16th, as well as the 3-day International Student Orientation August 18-21, 2013. Do you anticipate any conflicts with these dates? Yes No
If yes, please explain:
ESSAY QUESTIONS:
1. Why are you interested in the GA position?
2. Please share an experience which demonstrates your ability to interact effectively and work with diverse populations. 3. What is your philosophy regarding student behavior and accountability? 4. Describe your experience and skills related to program planning and implementation.
5. What challenges do you anticipate facing as a graduate assistant? In what ways will you address these challenges?
6. What skill set would you bring to the assistantship to be an effective employee?
REFERENCES
Please list the names and contact information for two references. Please note that one reference must be from a faculty/staff member on the RIT campus. The other reference should be someone who can speak to your qualifications as a potential RIT student leader
Name: Email: Phone:
I, (your name) understand that by signing this form, I declare all information given to be accurate and complete, and that I have read and understand the GA job posting. I also give the International Student Services permission to verify my employment eligibility, GPA and student conduct record. In addition, I give the ISS permission to post my name, e-mail address, photo and major on the ISS web site.
