TEXAS TECH UNIVERSITY
Department of Classical and Modern Languages and Literatures

DEPARTMENTAL APPLICATION FORM:
TEACHING ASSISTANT OR GRADUATE PART-TIME INSTRUCTOR, SPANISH

Name ____________________________________ Social Security Number______________________

Present Address ______________________________________________________________________

____________________________________________Zip Code ____________

Permanent Address ___________________________________________________________________

____________________________________________Zip Code ____________

Telephone _______________________ E-mail _________________________________

Citizenship Information:
U.S. Citizen ___
Foreign Citizen _______________
Legal Immigration Status________________ Immigration Number _________________

Degree Sought: M.A. _____ Ph.D. _____

When You Wish to Begin: Year____ Fall____ Spring____ Summer I____ Summer II____

Education:
Institution: ______________________________________ Dates ___________ Degree __________

Institution:______________________________________ Dates ___________ Degree __________

Institution:______________________________________ Dates ___________ Degree _________

Teaching Experience:___________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

___________________________________________________________________________________

Other Work Experience:________________________________________________________________

___________________________________________________________________________________

____________________________________________________________________________________

Return this form along w/ other application materials to:
Dr. Susan Isabel Stein
Dept. CMLL, ms. 2071
Texas Tech University
Lubbock, TX 79409-2071

Texas Tech University is an Equal Opportunity Employer

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