Graduate Assistantship and Fellowship Form- Continuing

Nominator and Department Information

Nominator Name

Nominator 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.

Funding Start Term

Admit Term (Current Program)

What is the financial commitment to the student? (Please indicate academic years. For example, 24/25 (for two years) etc.)

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

Full-Time (20 hrs per week)

Part-Time (10 hrs per week)