SU Home | Grad School Home | Contact PDP All-University TA Orientation Language Assessment / ITA Orientation Exemption Request [FORM E] Please refer to the criteria for exemption from language assessment and/or the cultural programming portion of the ITA Orientation on page 8 of your orientation packet. ***Exemption requests must be received by July 31, 2009.*** Name - First (Given): Middle: Last (Family): Syracuse University ID Number: E-Mail Address: Department in which you hold your TA appointment: I request exemption from: Language assessment      Cultural programming      Both 1 Do you currently reside in the United States? Yes      No      If yes, for how long? 2 Have you previously attended an academic institution in the United States? Yes    No   If yes, please provide:   Name of College or University:   Degree pursued: Did you complete the degree? Yes    No   Years of study from to Complete the following ONLY if applying for exemption from language assessment: 3 Are you a native speaker of English? Yes    No Country of Origin: 4 Have you taken the TOEFL test? Yes    No   If yes, please indicate where you took the test, the test date, and your score, if known.     University: City: State/Country: Test location:   Date: Score (if known): Test date (mm/dd/yyyy) If you took the TOEFL iBT, please indicate the scores on the speaking and listening sections: Speaking:    Listening: 5 While growing up, what language(s) did you speak in your home?   Language 1: Language 2: Language 3:   Language 4: Language 5:   6 Which language(s) can you speak with native or near-native proficiency?   Language 1: Language 2: Language 3:   Language 4: Language 5:   7 How long have you studied English? (Number of years, how many times per week, how many hours each day and where?) 8 Have you previously attended an academic institution where English was the language of instruction? Yes    No   If yes, please provide:   Name of College or University:   Degree pursued: Did you complete the degree? Yes    No   Years of study from to 9 If you have lived in an English-speaking country, have you enrolled in any "English as a Second Language" course(s)? Yes    No If Yes, please describe, including dates and place of attendance: 10 Other than at school, what opportunities do you have to speak English? 11 Do you watch American movies or TV programs, listen to American radio programs, etc.? How frequently? 12 Please note any other experiences or circumstances relevant to your English language proficiency. TA Program staff will notify you of the status of your exemption request. If you are requesting exemption from language assessment, a language specialist at Syracuse University will contact you to arrange a brief conversation (in person or by phone) to determine the level of your oral English language skills. Please give a number where you can be reached in July or early August.   Phone (include country/city code if not in the United States):   Best days of the week to call (Monday through Friday):   Best time of the day to call (9:00 a.m. - 5:00 p.m., Eastern Daylight Time (EDT)):   ***Exemption requests must be received by July 31, 2009.*** TA Program Future Professoriate Program (FPP) Professional Development Seminars (PDS) Back to Top Printable Version Email to Friend Home | Programs | Services | Special Events Awards | Resources | Research | Staff 423 Bowne Hall | Syracuse, NY 13244 | 315.443.1856 | taprog@syr.edu © Copyright 2002 Syracuse University | Privacy Policy