Last Name * First Name * Street Address * City * State * Zip * Email * WIN * Your nine-digit WMU Identification Number. ELRT Program * - Select -Educational Leadership (K-12)Educational Leadership (HE)Educational Leadership (OA)Educational Leadership (WFED)Evaluation, Measurement, & ResearchEducational & Instructional TechnologyOrganizational Change LeadershipOther If other, please explain * Graduate Level (at which you are studying) * MA Student Ph.D. Student Ed.S.Student Other If other, please explain * Relationship to ELRT Department * New Student Continuing Student Other If other, please explain * When do you anticipate graduating? * Who is your academic advisor? * Years/semesters that you have already held a GA/DA in ELRT (please note that, except in exceptional circumstances, the ELRT Department can only provide DA/GA opportunities or up to three years) In your GA/DA position(s) in ELRT, which faculty did you work with? * What were your responsibilities? * Please upload your current resume/CV * Upload Files must be less than 2 MB.Allowed file types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods xml. Certify * By submitting this form I certify the above and attached to be true. I authorize the release of the above and attached to the Department of Educational Leadership, Research and Technology's Scholarship Committee members and scholarship donors. I agree Leave this field blank Submit