ࡱ> npm ubjbjyy wx+ FF$P|n+t0LLLL'''*******$,/>*''*(+**5()<8G%4(*>+0n+(// q)/q),'hJ<5'''**6'''n+JJJJ/'''''''''F f:  APPLICATION FOR A TEACHING ASSISTANTSHIP POSITION YORK UNIVERSITY UNIT 1 (If you are registered at York as a full-time graduate student) NAME________________________________________TELEPHONE_______________________ surname given name ADDRESS_____________________________________POSTAL CODE_____________________ street city SUMMER ADDRESS ______________________________________________________________________ SUMMER PHONE ____________________ EMAIL ADDRESS ____________________________________________ SOCIAL INSURANCE NUMBER___________________ DATE OF APPLICATION___________________________ STUDENT NUMBER__________________________ TYPE OF TEACHING ASSISTANTSHIP APPLICATION (check one): Blanket  FORMCHECKBOX  Specific  FORMCHECKBOX  Please check yes or no if you wish to be considered for a ticketed course directorship: YES  FORMCHECKBOX  NO  FORMCHECKBOX  If you are applying for a ticketed course directorship, the required application information described in Article 10.01.1 and any additional information required by the Unit must be attached to this application form. Faculty________________________________Department/Division__________________________________ Note that a blanket application, to be considered, must be submitted between November 15 and January 31 (or by the next business day if January 31 falls on a week-end) and shall apply to all positions in the hiring unit for academic sessions that commence during the twelve months following January 31. Any application after January 31 is specific to the position or positions listed below. If you have any questions about how to fill in this application, please call the CUPE 3903 office at 416-736-5154. TEACHING ASSISTANTSHIP POSITIONS REQUESTED: (to be filled our even if you wish to be considered 1.___________________________________________ for a ticketed course directorship) (Even if this is a blanket application, please specify 2.___________________________________________ the position(s), course # and title, and academic session in which you are most interested.) 3.___________________________________________ PRESENT COURSE OF STUDY: Graduate Program_______________________________ ______Masters ______Ph.D. _____/_____/_____ Year of 첥Ƶ _______________ Entry Date 1st, 2nd etc. Graduate Supervisor ________________________ If applying for summer employment, are you a visa student?______________ PRIORITY POOL STATUS: Number of years (including current year) a full-time Ph.D. candidate _____________ TA assignments held at York while: a Masters candidate___________________ PREVIOUS TEACHING ASSISTANTSHIPS AT YORK: Including any currently held. Faculty/Course #/Title Year 첥Ƶ Level (e.g. LAPS/HIST2510/Canadian History) (e.g. 2013-14) (e.g. Ph.D. I) _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ EDUCATION: Begin with current. Degree & Discipline University Date Completed/In Progress 1.___________________________________________________________________________________________ 2.___________________________________________________________________________________________ 3.___________________________________________________________________________________________ 4.___________________________________________________________________________________________ TITLES OF COMPLETED, OR IN PROGRESS, HONOUR, MASTERS AND/OR PH.D. THESES: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ PUBLICATIONS: Give authors, titles and journal references. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CURRENT RESEARCH: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ RELEVANT GRADUATE LEVEL COURSE WORK: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ RELATED WORK OR ACADEMIC EXPERIENCE: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________ ______ Employment Equity (completion of this section is voluntary): The information below is important for the CUPE 3903 Joint Employment Equity Committee. A high response rate is critical to the ongoing development of the CUPE 3903 Employment Equity Plan. We ask that you please self-identify by checking one or more of the boxes below and submit it to the departmental administrative assistant. Please note that in order for this information to be useful we need you to include your Employee Number. Employee Number____________________________________ A. Visible minorities (racialized) are persons, other than Aboriginal peoples, who are non-Caucasian in race or non-white in colour, regardless of birthplace. Based on this definition, are you a visible minority (racialized)? Yes FORMCHECKBOX  No  FORMCHECKBOX  If yes, you are invited to check all that apply:  FORMCHECKBOX  Arab  FORMCHECKBOX  Black (e.g., African, American, Canadian Caribbean)  FORMCHECKBOX  Chinese  FORMCHECKBOX  Filipino  FORMCHECKBOX  Japanese  FORMCHECKBOX  Korean  FORMCHECKBOX  Non-White Latin American (including indigenous persons from Central and South America)  FORMCHECKBOX  Non-White West Asian (e.g., Iranian, Lebanese, Afghan)  FORMCHECKBOX  South Asian/East Indian (e.g., Bangladeshi, Pakistani, Indian from India, East Indian from Guyana, Trinidadian, Sri Lankan, East African)  FORMCHECKBOX  South East Asian (e.g., Burmese, Cambodian/Kampuchean, Laotian, Malaysian, Thai, Vietnamese, Indonesian) Persons with disabilities are those that have a long-term or recurring physical, mental, sensory, psychiatric or learning impairment and who: consider themselves to be disadvantaged in employment by reason of that impairment, or believe that an employer or potential employer is likely to consider them to be disadvantaged in employment by reason of that impairment. This also includes persons whose functional limitations owing to their impairment have been accommodated in their current job or workplace. Based on this definition, are you a person with a disability? Yes FORMCHECKBOX  No  FORMCHECKBOX  An Aboriginal (Indigenous) person is a North American Indian, Mtis, or Inuit and/or a Treaty Indian or a Registered Indian and/or member of an Indian Band/First Nation. Based on this definition, are you an Aboriginal (indigenous) person? YesR' No R' What is your gender identity?  FORMCHECKBOX  Man  FORMCHECKBOX Woman  FORMCHECKBOX Trans*  FORMCHECKBOX Gender Non-conforming Trans* includes, for example trans, transgender, transsexual, genderqueer, two-spirit, transwoman, transman LGBTQ2 is an umbrella term for persons who identify, for example as, lesbian, gay, bisexual, transgender, two-spirited, genderqueer, questioning, or who otherwise express gender or sexual diversity. Do you identify as LGBTQ2?  FORMCHECKBOX  Yes  FORMCHECKBOX  No *Trans includes, for example trans, transgender, transsexual, gender queer, two-spirit, transwoman, transmanIf under representation in certain designated groups is found, we will conduct focus group sessions to gain more information about potential barriers to employment. This will assist us in creating a work environment where every employee feels valued, respected and supported in achieving their career goals. May the Employment Equity Officer contact you to participate in focus groups? 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