Graduate Assistant Appointment Form Revisions

Graduate Assistant Appointment Form Revisions

This form can be used to revise a graduate assistantship appointment.

Questions about this form may be directed to Allyson Davis (allyson.davis@maine.edu).

Please note: This form cannot be saved and returned to later.

Prepared by (Email Address)*

Preparer First and Last Name*

Student Information

Student ID*

Student Last Name*

Student First Name*

Please check the boxes to indicate which item(s) you are revising:*

Please only select the aspects that are changing from the original appointment.

Stipend

New Monthly Rate

If the stipend amount is changing, please enter the desired new monthly rate and effective date here. Otherwise, leave blank.

New Start Date

Please enter a date here if the student's start date is changing. Otherwise, leave blank.

Note that start dates in the middle of a month will result in a prorated stipend.

New End Date

Please enter a date here if the student's end date is changing. Otherwise, leave blank.

Note that end dates in the middle of a month will result in a prorated stipend.

1-GL Distribution %*

1-GL Distribution Start Date*

1-GL Distribution End Date*

1-Source of Funding*

Provide the source of funding for each stipend line. This is used for annual reporting performed by the University and can affect future awards.

Select or enter value

1-Accounting ID (10 digits)*

1-GL Department (7 digits)

1-Account (5 digits)

1-Class (2 digits)

1-Fund (2 digits)

1-Program (5 digits)

1-Project (7 digits)

2-GL Distribution %

2-GL Distribution Start Date

2-GL Distribution End Date

2-Source of Funding

Select or enter value

2-Accounting ID (10 digits)

2-GL Department (7 digits)

2-Account (5 digits)

2-Class (2 digits)

2-Fund (2 digits)

2-Program (5 digits)

2-Project (7 digits)

3-GL Distribution Start Date

3-GL Distribution End Date

3-GL Distribution %

3-Source of Funding

Select

3-Accounting ID (10 digits)

3-GL Department (7 digits)

3-Account (5 digits)

3-Class (2 digits)

3-Fund (2 digits)

3-Program (5 digits)

3-Project (7 digits)

4-GL Distribution Start Date

4-GL Distribution End Date

4-GL Distribution %

4-Source of Funding

Select

4-Accounting ID (10 digits)

4-GL Department (7 digits)

4-Account (5 digits)

4-Class (2 digits)

4-Fund (2 digits)

4-Program (5 digits)

4-Project (7 digits)

Stipend Notes

Effective Academic Year*

Please indicate the academic year of the appointment that is being revised.

(Summer is considered the end of the academic year - ex. summer 2025 is part of AY24-25.)

Select

Insurance Coverage

The amount you input here will apply to the full year of health insurance unless you specify otherwise.

Insurance Account 1 - Percentage of Premium to be Paid - if student enrolls in UM plan*

Department and Fund codes are required for all accounts charged for insurance.

Insurance Account 1 - Department (7 digits)*

This field is required for insurance coverage.

Insurance Account 1 - Fund (2 digits)

This field is required for insurance coverage.

Insurance Account 1 - Class (2 digits)

Insurance Account 1 - Program (5 digits)

Insurance Account 1 - Project (7 digits)

Insurance Account 2 - Percentage of Premium to be Paid

Insurance Account 2 - Department (7 digits)

Insurance Account 2 - Fund (2 digits)

Insurance Account 2 - Class (2 digits)

Insurance Account 2 - Program (5 digits)

Insurance Account 2 - Project (7 digits)

Insurance Notes

Revisions are assumed to be for the current plan year - please specify if this revision is intended for a past year.