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J%%0&!x*1*$"$"&* J"}%%&* :  APPLICATION FOR A CONTRACT TEACHING POSITION YORK UNIVERSITY UNIT 2 (If you are not registered as a full-time graduate student at 첥Ƶ) NAME________________________________________ TELEPHONE_______________________ surname given name ADDRESS_____________________________________ POSTAL CODE_____________________ street city EMAIL ADDRESS_______________________________________ SOCIAL INSURANCE NUMBER___________________ DATE OF APPLICATION___________ TYPE OF APPLICATION : Blanket  FORMCHECKBOX  Specific  FORMCHECKBOX  In addition, I have Continuing Sessional Standing status and wish to participate in the program  FORMCHECKBOX  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. Applications must be accompanied by a curriculum vitae unless the department/division to which you are applying has a current c.v. on file. Blanket applications for members in the CSS program must be received by November 1 (or by the next business day if November 1 falls on a week-end). If you have any questions about how to fill in this application, please call the CUPE 3903 office at 416-736-5154. COURSES/POSITIONS REQUESTED: 1.___________________________________________ (Even if this is a blanket application, please specify the position(s), course # and title, 2.___________________________________________ and academic session in which you are most interested.) 3.___________________________________________ PRIOR EXPERIENCE IN TEACHING, DEMONSTRATING, TUTORING, MARKING AT YORK Calculations of applicable prior experience (Articles 12.06 - 12.08 of the collective agreement) can be made only on the basis of information supplied in this application. Note: Not all experience may be applicable to any particular position for which you are considered. See page 4 for further explanation. SUMMARY: Please transfer figures from detained calculations, pages 2 -3. (See page 4 for further explanation.) Number of years of experience:_____________________________________________ _____ Total number of years in each of which the applicant has accrued applicable prior experience of at least one Type 1 position or equivalent. _____ Total Type 1 positions (from pages 2-3). _____ Total Type 2 positions (from pages 2-3). _____ Total Type 3 positions (form pages 2-3). NOTE: If you are a member of one of the four designated Employment Equity Groups (women; members of visual/racial minorities; aboriginal peoples; persons with disabilities) and wish to self identify, please see the last page of this document) PRIOR EXPERIENCE: Position Title Position Type Faculty Course (see page 4) (Dept., Number, full/half, Title) EXAMPLE: TUTOR 1 Type 2 Atkinson SOSC 1700.06 Women in Canada EXAMPLE: C.D. Type 1 Arts SOCI 4350.03 International Migration _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ SESSION APPOINTMENT NO. OF ASSIGNMENTS/ EXPERIENCE STATUS GROUPS TAUGHT COUNT (CUPE 3903 Or Other - Specify) (See page 4) S 1984 Unit 1 2 2 Type 2 A/W 1985-86 Unit 2 1 1 Type 1 _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ _________________ ______________ _________________ ________________________ TOTALS: Type 1____________Type 2____________Type 3____________ (Please transfer to page 1) In completing pages 2 and 3, please list your experience at York, including all positions held at the time of application, by Type, proceeding from type 1 to type 3 (Article 10.04.1) and from oldest to most recent. Indicate fractional appointments. You may include all experience gained in CUPE 3903, whether in Unit 1 or 2. In addition, you may count certain other teaching/tutoring experience at 첥Ƶ held outside of CUPE 3903, as stipulated in Article 12.07 of the collective agreement. Your should include any experience accrued as a result of grievance, service on the CUPE 3903 Local or National Executive, in connection with leaves, as a result of Major Research and Teaching Development Grants. If necessary, use additional pages to list all experience. Calculate the total for each Type of experience and transfer the total(s) to page 1. Your applicable prior experience count is calculated as follows: Position Type times # of assignments, adjusted of course (full/half) and fractional. For example, two months of a course director position in a full course in A/W = .25 type 1; a full course director position in the summer=1 type 1; 2 tutor 1 positions = 2 type 2. The total, then, would be 1.25 type 1s and 2 type 2s. Article 12.06 explains equivalencies among types of experience, which will assist you in determining the number of years in which you held at least one type 1 or equivalent positions for the calculation page 1. POSITIONS BY TYPE Type 1: Type 2: Type 3: -Course Director -Tutor 1 (Tutorial Leader -Tutor 3 (Marker/Grader) -Team Lecturer -Tutor 2 (Demonstrator -Tutor 4 (Individual Tutor) -Writing Instructor 3 lab hours/week) - Computer Centre Advisor -Tutor 6 (Studio Instructor - Coach (Fine Arts) - Instructor (Faculty of Education) - Music Tutor If you have any questions about how to fill this application, please call the CUPE 3903 office at 416/736-5154. EDUCATION: Degree & Discipline University Date Completed (Begin with most recent) 1.____________________________________________________________________________ 2.____________________________________________________________________________ 3._____________________________________________________________________________ TITLES of PhD DISSERTATION and/or MASTERS THESIS: ______________________________________________________________________________ ______________________________________________________________________________ CURRENT RESEARCH: ______________________________________________________________________________ ______________________________________________________________________________ PUBLICATIONS: Give authors, titles and journal references. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ PREVIOUS RELEVANT EXPERIENCE (Outside York): ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ REFERENCE (Only Required if No Previous Teaching Experience at York): ______________________________________________________________________________ ______________________________________________________________________________ Please attach any additional information. ______________________________________________________________________________ Article 12.03.2, Article 23.04.2 (Conversion Appointments) and Article 24.07 *(Long Service Teaching Appointments) in the Unit 2 Collective Agreement contain provisions that have potential impact on members of 첥Ƶs five employment equity groups. If you wish to be considered pursuant to one of these provisions, please self-identify by checking one or more of the categories listed below. Further, 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. Whether the information in the first paragraph is relevant to you 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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