GRADUATE ASSISTANTSHIP INFORMATION FORM University of Texas - Pan

							                   GRADUATE ASSISTANTSHIP INFORMATION FORM
                          University of Texas - Pan American
                                Electrical Engineering
Students seeking an assistantship must (1) complete this information form, (2) attach copies of transcripts,
(3) a brief resume including prior work experience, and (4) attach a cover letter expressing your desire to
be considered for an assistantship. If you are not already a graduate student at UTPA, the above items
should be submitted as part of your departmental admission package. Return the items to:

                   Graduate Advisor, Electrical Engineering
                   The University of Texas - Pan American
                   1201 W. University Drive, Edinburg, TX 78539

(1) Application Date ________________
                            Month   Day      Year

(2) Indicate the position you wish to apply for:

         Teaching Assistant                  Research Assistant

(3) Indicate the academic year and semesters you wish to work:

   Year: _____-_____                         Fall      Spring           Summer             All

(4) Name __________________________________ Student ID _____________
            Last           First             Middle                              Leave blank if none


(5) Intended Degree Plan

         MSE in Electrical Engineering                Other (Indicate)__________________

(6) Admission Status

         Current Student at UTPA                      Seeking Admission to UTPA

(7) Current Mailing Address __________________________ Phone______________
                            __________________________ e-mail______________
                            __________________________
                            __________________________

(8) Permanent Address               __________________________ Phone______________
                                    __________________________ e-mail______________
                                    __________________________
                                    __________________________

(9) Are you currently an employee of UTPA?                              Yes                No
    Have you previously been employed by UTPA?                          Yes                No
(10) List any current or recent grants, awards, scholarships, or fellowships, if any.
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________

(11) Describe your research interests, and cite publications, if any. This section is
especially important if you are applying for a Research Assistant position.
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________
       __________________________________________________________

(12) (Optional) Indicate any additional information which may be useful in selecting you
for this position. You may attach additional pages if necessary.
         __________________________________________________________
         __________________________________________________________
         __________________________________________________________
         __________________________________________________________
         __________________________________________________________


NOTE: You must meet the requirements of the Federal Immigration Reform and Control Act to qualify for
this Assistantship.

(13) I CERTIFY that the information contained in this application and the attached
transcripts is true and correct.

__________________________________________Date____________________
Signature of Applicant