COURSE INFORMATION

Program:
Summer Session (credit-bearing)

Course Code

Course Name

Dates of Course

Name of Instructor

TEACHING ASSISTANT INFORMATION

Name of TA

Brown Status
Graduate
Undergraduate
Not Affiliated with Brown

Mailing Address

Telephone #

E-Mail Address

Have you ever worked with Brown before?
Yes
No

Have you ever filled out an I-9 form with Brown?
Yes
No

Has it been 3 years or longer since filling out an I-9 form with Brown?
Yes
No

Comments (Please use the space below to inform us of any unique details or comments re: your appointment that may be pertinent to processing your paperwork):

NOTE:
Within 2 business days of  submitting your form, you will receive an email from the Curriculum Logistics Office with follow-up information regarding the secure procedure for collecting your SSN. Thank You!