University Teaching Certificate Program Application (F25-W26)

University Teaching Certificate Program Application

Fall 2025 - Winter 2026
Instructions:

Fill out the electronic application form completely and attach all relevant documents.

All applicants must fulfill A & B:

A. Have taught for at least 3 quarters (UCR or other institution acceptable)

B. Have student evalutions from those 3 quarters

OR option C or D:

C. Completed (or will complete by end of Spring quarter) the Stay TA Ready Program (STAR) through the Teaching Assistant Development Program. Information here: https://tadp.ucr.edu/stay-ta-ready-certificate-program-0

D. Attended Teaching Careers Week - Teaching Development Track (spring quarter event held every year at UCR)

Any questions can be addressed to the UTC Coordinator, J Selke, at utc@ucr.edu.

Submit the application electronically by 9:00am on Friday, May 16, 2025. (Also make sure that your reference letter is submitted directly to utc@ucr.edu by this time as well.)
PERSONAL INFORMATION
Lived Name*

First NameLast Name
UCR NetID E-mail Address*
FLast001@ucr.edu
Student ID Number (SID)*
86xxxxxxx
ACADEMIC INFORMATION
Are you a postdoctoral fellow?*

YesNo
Degree Objectives*

Master'sPh.D.
Department or Program*
Graduate School Entrance Year*
Expected Graduation Date*
Quarter and Year
TEACHING EVALUATIONS
Your three quarter teaching evaluation requirement can be waived if you have participated in the Stay TA Ready Program (STAR) or Teaching Careers Week - Teaching Development Track and you select the box below.

I attended all sessions of the Teaching Careers Week - Teaching Development Track.I completed (or will complete by end of Spring quarter) the Stay TA Ready Program (STAR) through the Teaching Assistant Development Program.
If all 3 quarters of your teaching have taken place at UCR, please indicate below. We will review your last 3 quarters of teaching evaluations as part of our review of your application.
I have taught at least 3 quarters at UCR*

YesNo
Authorization to Access Teaching Evaluations*

I hereby authorize the GradSuccess Director to access my UC Riverside student evaluations for the purposes of evaluating my UTC application.
If some or all of your teaching has taken place at a different institution, please provide three quarters of recent teaching evaluations, including comments and numerical scores. Please convert these to one PDF and attach below.

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TEACHING EXPERIENCE
How many quarters have you served as a Teaching Assistant?*
How many total discussion sections have you taught as a Teaching Assistant at UCR?*
How many total lab sections have you taught as a Teaching Assistant at UCR?*
For how many courses have you been the sole instructor (responsible for all aspects of instruction and assessment) at UCR?*
Have you taught at institutions other than UCR?*

YesNo
Briefly describe your teaching experience outside of UCR (i.e., name(s) of institution(s), your position, etc.)
STATEMENT OF INTEREST
Provide a statement explaining your interest in the UTC program (what do you hope to get out of the program?), your general approach to teaching (what are your aims, methods, and values?), and your future career objectives (what career are you wanting to pursue after graduate school?). There is no maximum or minimum length, but around one thorough paragraph that extensively answers each question is suggested. Files should be submitted as a Word document or PDF.*

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REFERENCE
Your reference letter should, ideally, address some aspect of your teaching specifically.

Please instruct your recommender to email their recommendation letter directly to utc@ucr.edu by the due date.
Full Name of Reference (including title)*
Email Address of Reference*
example@example.com
Relationship to Reference (e.g. dissertation advisor, teaching supervisor, etc.)*
Acknowledgements and Signature
I certify that information contained in this application is true and complete. I understand that false information may be grounds for rejection of the application and immediate termination of certification participation at any point in the future if I am accepted into the program. I authorize the verification of any or all information listed above. I understand that acceptance into the program does not guarantee that a University Teaching Certificate will be awarded to me and that I must meet the minimum attendance and assignment requirements for GDIV 301/302. I further acknowledge that the final approval of my certification is contingent upon my completion of the requirements and approval from the Dean of Graduate Division and either the Director of GradSuccess or the Teaching Assistant Development Program Coordinator.
Signature*

Clear
Today's Date*

MonthDayYear
Date
Should be Empty:

University Teaching Certificate Program Application

PERSONAL INFORMATION

ACADEMIC INFORMATION

TEACHING EVALUATIONS

TEACHING EXPERIENCE

STATEMENT OF INTEREST

REFERENCE

Acknowledgements and Signature