Qualtrics Survey | Qualtrics Experience Management

After completing this application, email Sherilyn at svandewynckel@wlu.ca

your course schedule,

which lab sections fit your schedule (eg. CH110 Labs 1, 7, 12, 14 etc.)

and resume prior to

August 12th for Fall applications,

December 10th for Winter term

and April 20th for Spring term.

I will submit schedule, available Fall lab sections and resume by August 12th
I will submit schedule, available Winter Lab sections and resume by December 12th
I will submit schedule, available Spring lab sections and resume by April 20th

Full name:

WLU Student ID#:

Phone number:

Laurier email address:

Home address:

Street Address Line 1

Street Address Line 2

City

Country

State/Province/Country

Postal Code/Zip Code

Address during academic term:

Street Address Line 1

Street Address Line 2

City

Country

State/Province/Country

Postal Code/Zip Code

Year of program (as of September):

Major(s):

Have you been an instructional assistant before?

Yes

No

For which course(s)?

Have you ever received a Final Notice of Penalty with regards to a case of Academic Misconduct?

Yes

No

Prefer not to say

Why do you want to be an instructional assistant?

What qualities do you possess that will make you an excellent instructional assistant?

Briefly describe any teaching, lab and/or volunteer experience you have that is applicable to a position as an instructional assistant in the Department of Chemistry and Biochemistry:

Indicate the academic term(s) you wish to be an instructional assistant for:

Fall

Winter

Spring/summer

Identify the chemistry and/or biochemistry course(s) you are interested in being an instructional assistant for: If you are interested in more than one course, rank the courses according to your preference (e.g. (1) first choice, (2) second choice, (3) third choice, etc. Or list all the courses with "no preference" at end of list.

List chemistry courses you have taken along with the grade you received (e.g. CH110 B+, CH202 A-). Include your lab section and/or TA/IA, if known.

List any chemistry courses you are currently taking or are enrolled in for upcoming term:

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