APPLICATION FOR GRADUATE FELLOWSHIP OR ASSISTANTSHIP

This form and the necessary enclosures must be forwarded to the chairperson of the major department.

Name of Applicant ______________________________________________________________

LAST, FIRST, MIDDLE

Present Address ____________________________________________________________ ___

NUMBER AND STREET, CITY, STATE, ZIP CODE

Home Phone (____) ____________ Work Phone (____) ___________ Fax (____)___________

May we call you at work? Yes / No

e-mail______________________________

Sex: Male / Female

Birthdate ____________ MONTH/DAY/Y EAR

Social Security Number_________________(IF AVAILABLE)

Citizenship ______________________________

(Non-US citizens) Are you a US national or US permanent resident? YES / NO

Knowledge of Foreign Languages: ___________________________ READING / WRITING / SPEAKING

Major Department ____________________ ________ College __________________________

Degree(s) sought _________________ Area of Specialty _______________________________

Check type of support requested: Check first term for which support is desired:

Graduate Teaching Assistantship Fall 200___

Graduate Research Assistantship Spring 200___

Graduate Fellowship Summer A 200___

Graduate Fellowship for Minority Students Summer B 200___

Florida law requires international teaching assistants to demonstrate oral proficiency in English. The international students from non-English speaking countries must present an adequate score on the Test of Spoken English (TSE) in order to hold a Teaching Assistantship at the University of Florida.
TSE score (IF AVAILABLE)_____   Test date (OR INTENDED DATE) __________

Have you previously held a fellowship at the University of Florida? Yes / No

List below three faculty members who are familiar with your work and have been asked to send letters of recommendation directly to your major department.

1. ____________ _______________________________________________(____)_________

NAME, INSTITUTION, TELEPHONE

2. ___________________________________________________________(____)_________

NAME, INSTITUTION, TELEPHONE

3. _____________________ ______________________________________(____)_________

NAME, INSTITUTION, TELEPHONE

NOTE: Three letters are required; at least one letter should refer to your most recent studies. Additional informal letter s may also be submitted. A standard recommendation form is enclosed. Letters may be typed on letterhead and attached.

On a separate page: (1) Describe in a short essay any additional qualifications which you may have for the appointment you are seeking. Include such items as employment experience, research writing, laboratory experience, artistic creation, inventions, travel, and other relevant skills. (2) Give a brief description of your plans after completing graduate work.

I certify that all of the above information is accurate to the best of my knowledge

______________________________________ __________________
SIGNATURE OF APPLICANT/ DATE

The University of Florida does not discriminate on the basis of age, race, color, national or ethnic origin, religious preference, disability, or sex in any aspects of its operations.