New Parent Accommodation for Graduate Assistants: Request Form

Graduate Assistants desiring accommodations under the "New Parent Accommodation for Graduate Assistants and Postdoctoral Trainees" guideline must complete this form as soon as possible after the date of the anticipated birth or adoption is known, and submit it to the Associate Dean for Graduate Studies. The Associate Dean will notify the graduate assistant, the program, and the Graduate School regarding the outcome of the request.

Student First Name

Student Last Name

Student Email

Graduate Program

Thesis Advisor Name

Thesis Advisor Email

Due Date/Adoption Date

Anticipated Date to Start Leave

Anticipated Date of Return

Responsibilities During Accommodation

I will not have any responsibilities related to my assistantship during my accommodation.I have agreed to responsibilities related to my assistantship during my accommodation (specify below).

Describe Responsibilities You Have Agreed to Complete During Accommodation:

Your submission of this form constitutes your agreement to the information stated here. Upon submission, your thesis advisor will be emailed a notification to complete their verification of this information. Accommodations cannot be processed without advisor validation; please work with your advisor to ensure they complete the next step.

Contact Information