ࡱ> _a^ >Objbj~~ wRlklkG% CCC$gggPL4g2t7j11111114<7J1EC""""1"1###"F8C1#"1##/h+=0 ;4N"di/q1102y/7"7 =07C=04hM J# < 5114#2""""7 :  APPLICATION FOR A TEACHING ASSISTANTSHIP POSITION YORK UNIVERSITY UNIT 1 (If you are registered at 91ɫ as a full-time graduate student) NAME________________________________________TELEPHONE_______________________ surname given name ADDRESS_____________________________________POSTAL CODE_____________________ street city SUMMER ADDRESS ______________________________________________________________________ SUMMER PHONE ____________________ EMAIL ADDRESS ____________________________________________ SOCIAL INSURANCE NUMBER___________________ DATE OF APPLICATION___________________________ STUDENT NUMBER__________________________ TYPE OF TEACHING ASSISTANTSHIP APPLICATION (check one): Blanket  FORMCHECKBOX  Specific  FORMCHECKBOX  Please check yes or no if you wish to be considered for a ticketed course directorship: YES  FORMCHECKBOX  NO  FORMCHECKBOX  If you are applying for a ticketed course directorship, the required application information described in Article 10.01.1 and any additional information required by the Unit must be attached to this application form. 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. If you have any questions about how to fill in this application, please call the CUPE 3903 office at 416-736-5154. TEACHING ASSISTANTSHIP POSITIONS REQUESTED: (to be filled our even if you wish to be considered 1.___________________________________________ for a ticketed course directorship) (Even if this is a blanket application, please specify 2.___________________________________________ the position(s), course # and title, and academic session in which you are most interested.) 3.___________________________________________ PRESENT COURSE OF STUDY: Graduate Program_______________________________ ______Masters ______Ph.D. _____/_____/_____ Year of Study _______________ Entry Date 1st, 2nd etc. Graduate Supervisor ________________________ If applying for summer employment, are you a visa student?______________ PRIORITY POOL STATUS: Number of years (including current year) a full-time Ph.D. candidate _____________ TA assignments held at 91ɫ while: a Masters candidate___________________ PREVIOUS TEACHING ASSISTANTSHIPS AT YORK: Including any currently held. Faculty/Course #/Title Year Study Level (e.g. LAPS/HIST2510/Canadian History) (e.g. 2013-14) (e.g. Ph.D. I) _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ _____________________________________________ ___________________ ___________________ EDUCATION: Begin with current. Degree & Discipline University Date Completed/In Progress 1.___________________________________________________________________________________________ 2.___________________________________________________________________________________________ 3.___________________________________________________________________________________________ 4.___________________________________________________________________________________________ TITLES OF COMPLETED, OR IN PROGRESS, HONOUR, MASTERS AND/OR PH.D. THESES: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ PUBLICATIONS: Give authors, titles and journal references. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CURRENT RESEARCH: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ RELEVANT GRADUATE LEVEL COURSE WORK: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ RELATED WORK OR ACADEMIC EXPERIENCE: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________ ______ CUPE 3903 Employment Equity Self-Identification Form Confidential when completed. Self-Identification Survey results will be shared only on a need-to-know basis for the purposes outlined below. "Count yourself in!" The information collected may be used, pursuant to the relevant provisions of the collective agreement, to inform certain appointment decisions and support the assessment of whether equity requirements are being met. We need everyone, including those who do not identify as members of an equity group, to complete the Employment Equity Self-Identification Survey. In addition, the information collected will be used on an aggregated basis for reporting purposes. Your information will also help us to prevent or address systemic barriers to access and opportunity, set, promote and measure equity, diversity and inclusion goals, and improve the work experience for all of 91ɫ's employees. It is important to capture your identity to build awareness and ensure resources are made available to all employees including members of equity-seeking groups. You are encouraged to complete your Self-Identification Survey each time you submit an application. You may self-identify under more than one of the designated groups. If you choose not to complete the survey, please let us know by checking the box in Question "7" before submitting the form. If you choose not to complete the survey, you have the option to provide feedback as to why. If you identify as a person with a disability, please contact the Employee Well-Being office (HYPERLINK "mailto:ewb@yorku.ca"ewb@yorku.ca) if you need any workplace accommodation. You may also contact the CUPE 3903 Staff Representative Equity (HYPERLINK "mailto:equity@cupe3903.org"equity@cupe3903.org). Please see HYPERLINK "/vpepc/employment-equity/"/vpepc/employment-equity/ for more information on Employment Equity at York University. Do you identify as an Indigenous person? % Yes % No Do you identify as a racialized person (visible minority)? % Yes % No Do you identify as a person with a disability? % Yes % No Do you identify as a woman (regardless of whether you are cisgender/assigned female at birth or trans)? % Yes % No Do you identify with one or more of the categories included in 2SLGBTQIA+ (Two Spirit, Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual)? % Yes % No Contact / Focus Groups In our work to increase the inclusivity of the work environment, whereby every employee feels valued, respected and supported, we often seek input from York employees on initiatives specifically aim4EMNOI V W e f 6 e ӷӷөөөөөөwkөh}CJOJQJaJ'jhe:h}CJOJQJUhe:h}CJOJQJ!jhe:h}CJOJQJUh}CJOJQJmH sH hACJOJQJmH sH h8#CJOJQJmH sH hACJOJQJmH sH hA5CJOJQJmH sH hA5CJOJQJmH sH *4EMOI V W 6 e Z <gde:<gd}xgd}xgde:`gdA`gdAgdA HgdA Z ^ _ m n o t u ^ _ `  Ϳ͚zpffXJJJJJJhACJOJQJmH sH he:CJOJQJmH sH he:CJOJQJh}CJOJQJ'jFh}h}CJOJQJUh}CJOJQJaJ'jh}hzCJOJQJU!jh}h}CJOJQJUh}CJOJQJmH sH h}h}CJOJQJ!jhe:h}CJOJQJU'jvhe:hdPCJOJQJU _ ` GHLt hi7dexgd{@ `@ gdAgde:gdmwxgdmwxgd}gdA GHLt  7hi򇇕xj\\\h{CJOJQJmH sH h}CJOJQJmH sH h}5CJOJQJmH sH he:CJOJQJmH sH hmwCJOJQJmH sH hA5CJOJQJmH sH hmw5CJOJQJmH sH he:5CJOJQJmH sH  h}56CJOJQJmH sH  hA56CJOJQJmH sH hACJOJQJmH sH $")67S\cdecd "#LϽޯޯwwiwiwhe:CJOJQJmH sH h>|CJOJQJmH sH hRCJOJQJmH sH h{CJOJQJmH sH hFjCJOJQJmH sH hACJOJQJmH sH #h>|hA6CJOJQJmH sH h{5CJOJQJmH sH hA5CJOJQJmH sH #h>|hA6CJOJQJmH sH )d"#y%{'})*JL SxxgdRgdALQy%NR{'PT})*3JLMou?DKL =>RS\xyժh>|5CJOJQJmH sH he:CJOJQJmH sH h|CJOJQJmH sH hA5CJOJQJmH sH hACJOJQJmH sH hRCJOJQJmH sH Byz^_7 8 9 : ; < = > ? @ b!1$gdX~ $$1$@&gdX~ Hgd[gdAyz:]^_U ! 6 7 8 9 : ; < ŷө{{jjYY hG^5>*CJOJQJmH sH  he:5>*CJOJQJmH sH h $CJOJQJmH sH  h01.hACJOJQJmH sH h01.5CJOJQJmH sH h01.CJOJQJmH sH he:CJOJQJmH sH h>|CJOJQJmH sH hACJOJQJmH sH hA5CJOJQJmH sH he:5CJOJQJmH sH < = > ? @ a!b!c!""$$r%s%L&M&&&&ʹxxk[[k[[[[[[[[[F[(jhX~h9CJOJPJQJUhhX~h9CJOJPJQJhhX~CJOJPJQJh.hX~h95B*CJOJPJQJ\hph6_(hX~5B*CJOJPJQJ\hph6_&hhe:5>*CJOJQJmH sH  he:5>*CJOJQJmH sH &hh[5>*CJOJQJmH sH  hC5>*CJOJQJmH sH  h05>*CJOJQJmH sH b!c!"$s%M&'r(((`)))*** ,D,F,t,MM$N@NNOO$$d1$@&gd9 d1$gd9&&&&&E'F'l'm'n''''''''''''p(r((((((^)`)))))*******,ӽӭӭӽӭӭ}ӽӭjjjjjjjjjj%hX~h95CJOJPJQJ\h.jDhX~h9CJOJPJQJUh.jhX~h9CJOJPJQJUhhX~h9CJOJPJQJh+hX~h9>*B*CJOJPJQJhph(jhX~h9CJOJPJQJUh.jhX~h9CJOJPJQJUh),, ,B,D,F,r,t,.L:MMMMM"N$N>N@NBNNNNOOOOO O"O$O&O(O*O,O.O0O2O4O6O8O:OOİܙ܆~zz~zz~zz~zzvrrvh9hPhW jhW U%h95B*CJOJQJ\aJph,jhX~h9CJOJQJUmHnHu#hX~h9CJOJPJQJ^JhU.hX~h95B*CJOJPJQJ\hphOhX~h9CJOJPJQJh%hX~h95CJOJPJQJ\h+ed at reducing potential bias and/or barriers in the employment/student life cycle. 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