Job Title: Math Studio Teacher S Aide in the Department of Mathematics

On our Payroll Studio Application Undergraduate Hourly Positions ONLY Job Title: Math Studio Teacher’s aide in the Department of Mathematics Please complete all areas in ink and return this application to 138 Cardwell Hall. Resume may be included but will not substitute for application. Note: To be hired on the student hourly payroll in the Mathematics Department, you must be enrolled in at least 6 credit hours during the Fall and Spring semesters. The deadline for submitting this application is April 15. Current mathematics student hourly’s in good standing should use the re-apply application form.

All information requested on this application is required for the position: Name WID Date Local address street: Perm. address street: City, State, Zip City, State, Zip Local phone number: Perm. phone number: Electronic mail addresses: Major(s)/Minor(s) Year Grades in College Level Mathematics: K-State GPA How many hours do you plan to enroll in the semester for which you are applying Will you have College Work Study (CWS)? Yes No If yes: Estimate the amount available per semester $ FWS is preferred for this position. Will you be employed elsewhere on campus? Yes Maybe No If Yes: What department(s)? How many hours/week What payroll will you be on? (Please Circle One) Student Hourly GTA GRA Other Please indicate the number of hours per week you want to work: Minimum Maximum If your native language is not English, please indicate your TOEFL and TSE scores: TOEFL TSE

Please check the times you are available to act as a math studio teacher’s aide. Time Thursday Friday 9:30 AM-10:20 AM 10:30 AM-11:20 AM 11:30 AM-12:20 PM 1:30 PM - 2:20 PM 2:30 PM - 3:20 PM 4:30 PM - 5:20 PM

I certify that the above information is correct to the best of my knowledge. I also give permission for the Department of Mathematics to contact past supervisors and/or references listed above regarding my qualifications and past work performance.

. Applicant Signature Date Kansas State University prohibits discrimination on the basis of race, color, ethnicity, national origin, sex (including sexual harassment and sexual violence), sexual orientation, gender identity, religion, age, ancestry, disability, genetic information, military status, or veteran status, in the University's programs and activities as required by applicable laws and regulations. The person designated with responsibility for coordination of compliance efforts and receipt of inquiries concerning nondiscrimination policies is the University's Title IX Coordinator: the Director of the Office of Institutional Equity, [email protected], 103 Edwards Hall, Kansas State University, Manhattan, Kansas 66506-4801, 785-532-6220. The campus ADA Coordinator is the Director of Employee Relations, [email protected], who may be reached at 103 Edwards Hall, Kansas State University, Manhattan, Kansas 66506-4801, 785-532-6277.

Revised July 7, 2015.