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*

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.