OKLAHOMA STATE UNIVERSITY



OKLAHOMA STATE UNIVERSITY

Biosystems & Agricultural Engineering Department

Application for Graduate Assistantship

|DATE: | |

|Position for which you are applying: |Research | |Teaching | |Extension | |

|1. |Name: | | | | | |

| | |Family or Last | |Given or First | |Middle |

|2. |Social Security Number: | |

|3. |Mailing Address: | |

|4. |Home Phone: | |Business Phone: | |

|5. |E-mail: | |

|6. |Citizen|U.S. | |Yes | |

| |ship: |Citizen? | | | |

|7. |Scholastic Training: |

NAME OF INSTITUTION YEARS ATTENDED

|Secondary School |From |To |Date of Graduation |

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|College or University | | |Degree |Date |

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|Graduate Study | | | | |

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|8. |Title of Master’s thesis: |

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|9. |Major subjects studied: |

| | Undergraduate work - | |

| | Graduate work - | |

| | Other education programs - | |

|10. |Honors: honorary societies, scholarships, prizes, etc. (optional). |

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|11. |Membership in professional societies (optional). Indicate the amount of work you have completed toward any degree higher than those you |

| |hold. If your attendance was on a part time basis, indicate the full-time equivalent. |

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|12. |Other skills, abilities, and languages (oral and written that you would like to disclose). (optional) |

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|13. |Publications. (Please submit a list of your publications on a separate sheet. Submit copies of your most important publications, if |

| |available.) |

|14. |Submit a list of any scientific discoveries, inventions, original designs, art awards, etc. |

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|15. |List teaching or professional experience in chronological order with most recent position first: |

Nature of Duties (if teaching

Title of Position Company or Organization Dates position, list subjects taught)

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|16. |References: Names of at least three persons from whom information concerning you may be obtained. ***Include mailing address, telephone|

| |number, email address and fax number. |

|A. |

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|B. |

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|C. |

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|D. |

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|17. |Send transcripts of all undergraduate and graduate work, if you have not already submitted them with your application to the Graduate |

| |College. |

1 Oklahoma State University, in compliance with Title VI and VII of the Civil Rights Act of 1964, Executive Order 11246 as amended. Title IX of the Education Amendments of 1972, Americans with Disabilities Act of 1990, and other federal laws and regulations, does not discriminate on the basis of race, color, national origin, ex, age, religion, disability, or status as a veteran in any of its policies, practices or procedures. This includes but is not limited to admissions, employment, financial aid, and educational services.

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