Application Form For Employment In The Chemistry Department (Page 2 of 2) in pdf

Application Form For Employment In The Chemistry Department Page 2

Application Form for Employment in the Chemistry Department

Term (circle): FALL SPRING

Year:__________

Name: ____________________________________________________________________________________

Expected Graduation Date: _______________________________ Email: _____________________@duke.edu

Durham Mailing Address: _____________________________________________________________________

Durham Phone #: ______________________________ Choose one:

Chem Major

Chem Minor

Neither

1. If you would like to be considered for an Undergraduate Teaching Assistant (UTA) or an Undergraduate Prep

Room Assistant (UPRA) position indicate your 1

, 2

, and 3

choice, etc., for all positions you would consider.

a. Core Concepts in Chemistry 101

___Lab ___Recitation

b. Modern Applications Chemistry 210

___Lab ___Recitation

c. Organic Chemistry 201

___Lab

d. Organic Chemistry 202

___Lab

e. Undergraduate Prep Room Assistant

___

2. If applying for a Laboratory UTA position, indicate which sections you would be available to teach (circle all that apply and

indicate your first, second choice if applicable)

Morning Lab (201, 202) (8:30 am – 11:30 am) Tu ___

Afternoon Lab in General (101, 210) or Organic Chemistry (201, 202):

(1:25 – 4:25 pm) M___ Tu ___ W___ Th ___ F___

3. If applying to be a Recitation UTA or UPRA, indicate times between 9-5 pm M-F that you will be available.

4. Have you been previously employed by the Chemistry Department? ___Yes

___No

If so, check each that applies:

___ UTA (undergraduate teaching assistant)

What course and when? _____________________

___ UPRA (undergraduate prep room assistant) When? _____________________

5. How much time can you spend working for the Chemistry Department?

Maximum ___hrs/wk

Minimum ___hrs/wk

Optimal ___hrs/wk

6. List the courses you have taken in the Chemistry Department, and your grade in each.

Application Form For Employment In The Chemistry Department Page 2