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Information Submission and Request for Assignment

Important Note: The University now requires a Background Check on all student employees. In order to be hired, you must submit the Release Form. Download this Form and submit it to the Dr. Jezercak if you are to be hired.

This form is for those wishing to work as a Chemistry Department Laboratory Assistant. Please consult the semester lab schedule for openings before proceeding. Make requests only for those labs for which you are certain that you will be able to work with regard to scheduling and ability.

Please provide the following contact information:

First Name
Last Name
Home Phone
E-mail

Please provide your UCO Student ID number:

Student ID Number  

Please provide your Social Security number:

Social Security Number  

Are you an international student? (Select One) Yes    No

Are you currently enrolled? (Select One) Yes    No

Please identify and describe yourself:

What chemistry labs have you had?

If you took your lab courses here at UCO, please include the name of your instructor.


To which labs would you like to be assigned? (See the laboratory schedule for openings)

IMPORTANT - Request only the labs that have not been assigned a laboratory assistant. Check the correct Fall, Spring or Summer schedule using the links above before making a request.

 

  • Semester:
  • Lab Name:      Day: Time:
  • Lab Name:      Day: Time:
  • Lab Name:      Day: Time:
  • Lab Name:      Day: Time:
  • Lab Name:      Day: Time:

Do you have any other requests or comments?

Before submitting: Have you checked to see if the labs you requested are available?