University Teaching Certificate Program Application Fall 2021- Winter 2022 Cohort Instructions: Fill out the electronic application form completely and attach all relevant documents. All applicants must fulfill A & B: A. have taught for at least 3 quarters (UCR or other institution acceptable) B. have student evalutions from those 3 quarters OR option C: attended Teaching Careers Week - Teaching Development Track (spring quarter event held every year at UCR) Any questions can be addressed to the UTC Coordinator, Kyla Rankin, at utc@ucr.edu. Submit the application electronically by 9:00am on Monday, May 17, 2021. (Also make sure that your reference letter is submitted directly to utc@ucr.edu by this time as well.) Personal Information: First Name * Last Name * Preferred First Name (if it is the same as your first name, rewrite it here) * UCR Email Address * Phone Number * - Area Code Phone Number Academic Information: Student ID Number * Which of the following options applied to you? * I am a Postdoctoral Fellow I am a GAANN Fellow I am neither Department/Program * Degree Objective * Master's or PhD Graduate School Entrance Year * Expected Graduation Date * Teaching Evaluations: Your three quarter teaching evaluation requirement can be waived if you have participated in the Teaching Careers Week - Teaching Development Track and you select the box below. I have participated in the Teaching Development Day - TA Development Track If all 3 quarters of your teaching have taken place at UCR, please indicate below. We will review your last 3 quarters of teaching evaluations as part of our review of your application. I have taught at least 3 quarters at UCR. * Yes No Authorization to Access Teaching Evaluations * I hereby authorize the GradSuccess Director and UTC Coordinator to access my UC Riverside student evaluations for the purposes of evaluating my UTC application. If some or all of your teaching has taken place at a different institution, please provide three quarters of recent teaching evaluations, including comments and numerical scores. Please convert these to one PDF and attach below. Browse Files Cancel of Teaching Experience: How many quarters have you served as a Teaching Assistant? * How many total discussion sections have you taught as a Teaching Assistant at UCR? * How many total lab sections have you taught as a Teaching Assistant at UCR? * How many courses have you been the sole instructor (responsible for all aspects of instruction and assessment) at UCR? * Have you taught at other institutions than UCR? * Yes No Briefly describe your teaching experience outside of UCR (i.e., name(s) of institution(s), your position, etc.). * Statement of Interest: Provide a short statement explaining your interest in the UTC program (what do you hope to get out of the program?), your general approach to teaching (what are your aims, methods, and values?), and your future career objectives (what career are you wanting to pursue after graduate school?). There is no maximum or minimum length, but around one paragraph per question is suggested. Reference: Your reference letter should, ideally, address some aspect of your teaching specifically. Please instruct your recommender to email their recommendation letter directly to utc@ucr.edu. Full Name of Reference (including title) * Email Address of Reference * faculty.member@ucr.edu Relationship of Reference to you (e.g. dissertation advisor, teaching supervisor, etc.) * Acknowledgements and Signature: I certify that information contained in this application is true and complete. I understand that false information may be grounds for rejection of the application and immediate termination of certification participation at any point in the future if I am accepted into the program. I authorize the verification of any or all information listed above. I understand that acceptance into the program does not guarantee that a University Teaching Certificate will be awarded to me and that I must meet the minimum attendance requirements for GDIV 301. I further acknowledge that the final approval of my certification is contingent upon my completion of the requirements and approval from the Dean of Graduate Division and the Director of GradSuccess. Full Name: The name below constitutes my typed electronic signature. By typing my name, I certify that everything in my application is accurate to the best of my knowledge * Today's Date * - Month - Day Year Date Submit Should be Empty: