Application For International Teaching Assistant Courses (Itap) Form

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Application for ITA Courses
International Teaching Assistant Program (ITAP)
Course History: Please check any courses you have completed
I am applying for:
or are currently enrolled in:
General Information:
☐GRAD 7302 ☐GRAD 7303 ☐GRAD 9304
Semester/Year
☐ELSP 400
_____________________________
During the following semester:
☐Summer (only GRAD 7303)
☐GRAD 7302
_____________________________
☐GRAD 7303
_____________________________
☐Fall
☐Spring
Name: __________________________________________________________________________
☐Accent Reduction Program
_____________________________
☐IEP Classes: _________________________________________________________________
Student Number: _____________________________________________________________
☐Adult Education: ___________________________________________________________
Teaching Department ________________________________________________________
Eligibility: Please check one of the boxes below:
Email: __________________________________________________________________________
I am eligible for GRAD 7302 because
☐ I have completed ELSP 400
Number of hours you will take in addition to GRAD course: ______________
☐ I received 2P on my most recent language assessment and GRAD
7302 was recommended at that time.
During the semester I will be a TA/GI: (circle)
yes
no
I am eligible for GRAD 7303 because
☐ I have completed GRAD 7302
If yes, what classes/sections and what are your total teaching hours:
☐ I received a 2 or 3P on my most recent assessment and GRAD 7303
was recommended at that time.
Oral Assessment: Please list screening results beginning with
______________________________________
#/ hours: ___________
the most recent:
I am eligible for GRAD 9304 because
☐ I have completed GRAD 7302 and GRAD 7303
☐ I received a 3 on my most recent language assessment and
GRAD 9304 was recommended at that time.
Month & Year
Assessment Type
Level
☐SPEAK
☐OPT
☐SPEAK
☐OPT
I believe this student would be seriously considered for a GI/TA/RA
Departmental Endorsement:
☐SPEAK
☐OPT
All applicants wishing to take a class must be screened before the
position involving classroom instruction if his/her oral language
beginning of the semester. If you have not been screened, please give
competency improved. The language level needed is: ___________
the date you are scheduled to be tested:
Signature: __________________________________________
Title: ____________
Date: _____________________
☐SPEAK
☐OPT

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