ONLINE GRADUATE ASSISTANTSHIP APPLICATION

* denotes required fields.

Today's Date:


*Program Enrolled: Other:
I. PERSONAL DATA
Name

*First Name

*Last Name

Middle Name
Present Address

*Address

*City

*State

*Zip
Contact Information
###-###-####
Home Phone
###-###-####
Work Phone

Email Address
Type of Position Preferred
*A. Full-Time Part-Time
*B. Administrative Teaching Research
Indicate general field and subject in field:
*Available to begin: mm/dd/yy
Cell Phone:
###-###-####
*Degree Type:
*PID:
When do you expect to complete your degree? mm/yy
FEDERAL LAW REQUIRES PROOF OF RIGHT TO WORK IN THE U.S. (within three days of employment)
*Are you a U.S. Citizen? Yes No
If not, please indicate if you are are authorized to work in the United States by checking the box below.
By checking this box, I am indicating that I am authorized to work in the United States.
*Are you a Florida resident? Yes No
Note: To qualify for residency, you must be living in Florida for at least one year.
III. UPLOAD RESUME (to include EDUCATION, PROFESSIONAL PREPARATION and EMPLOYMENT HISTORY)

Please be sure to include the following information on your resume:

Educational and Professional Preparation

  • Name and location of Colleges & Universities attended (Include all Undergraduate & Graduate Colleges attended.)
  • Type of Degree received
  • Dates attended (From - To)
  • Year Degree awarded
  • Major field

Employment History

  • Dates (From - To)
  • Name & Address of Institution, Business or Organization
  • If in teaching, specify: Field Taught, Full-Time/Part-Time, Rank
  • If other than teaching, state position and type of work
*Upload Resume (MS Word format accepted ONLY):

*May we make an inquiry of your present employer regarding your qualifications? Yes No

IV. REFERENCES

Please list names, addresses and phone numbers of three or more persons qualified to assess your training, experience and personal qualities. Include and designate two or more persons who can comment on your teaching effectiveness.

Name & Title Company/Organization Phone Number
REFERENCE 1
REFERENCE 2
REFERENCE 3
REFERENCE 4

*Have you been convicted of a felony or first degree misdemeanor? Yes No

If yes, what charge(s)?
Where convicted: Date convicted: mm/dd/yy

Note: A "yes" to this question will not necessarily bar you from employment. The nature, severity and date of the offense in relation to the position for which you are applying are considered.

*Have you been convicted of a felony for the sale of trafficking in or conspiracy to sell or traffic in a controlled   substance committed in or after October 1990? Yes No

If the answer is 'Yes', Chapter 893, F.S. requires you to contact the Employment Division for additional background information before you can be considered for employment with the State University System.

*Employees of the University of Central Florida, as in all other state agencies, are required to take the Oath of Loyalty to the United States and the State of Florida.

I agree that the background investigation may be conducted to verify professional qualifications and       experience and may include or involve contact with persons not listed in the above application.