Graduate Assistantship and Fellowship Form- New

This form should only be used for students funded through the Graduate School, e.g. a GTA line. Do not use this form for internal funding, i.e. departmental scholarships or grants, and other funding sources external to the Graduate School.

Are you submitting this form for a new student enrolling in the upcoming semester or a continuing student in your program?

New

Continuing

We have a special form for continuing students. Please submit the form using this link.

Submitter and Department Information

Submitter Name

Email Address

Department Name

Name of Department Chair

Name of Director of Graduate Studies

Name of Associate Dean

Name of Dean

Name of Unit Business Manager

Student Information

Student ID Number

First Name

Last Name

Email Address

Classification Level

Academic Plan

If the academic plan is not listed above, please type it here.

Admit Term (Current Program)

Funding Start Term

Is this student a part of the MD/PhD Program?

Yes

Is this a full- time or part-time stipend?

Full-Time (20 hrs per week)

Part-Time (10 hrs per week)