Cornell Engineering : AEW Application

Last Name:

First Name:

Local Address:

City:

State:

Zip Code:

Phone :

Net ID:

Expected Graduation Month :

December

May

August

Expected Graduation Year:

ie. 2009, 2010, etc.

Have you particpated as a student in an AEW:

Yes

If yes, briefly describe your experience:

If not, have you discussed AEWs with others:

If yes, briefly state your impressions:

Goals as described below:

What would you like to achieve, personally & academically, from your participation as a facilitator?

Teaching experience as described below:

Please describe any teaching, tutoring, coaching, or cooperative learning experiences you have had at Cornell or elsewhere.

What course(s) would you prefer to facilitate:

Please list grades from above named courses:

Self assessment as described below:

Please provide a self-assessment of your abilities in the courses you would like to facilitate (include grades relevant to courses).

What is your GPA:

Ethnicity:

Please choose the option that best fits you.

If International student, list country of origin:

Gender:

Male

Female

Please list days/times for a possible interview: