Housing and Residence Life
New Community Assistant Application
CANDIDATE INFORMATION
Last Name:
Semester Applying For:
Middle Initial:
First Name:
Permanent Address:
Date of Birth:
On Campus Address:
Cell Phone Number:
KU Email Address:
Student ID Number (9 digits)
Work Authorization # (from HR):
Major:
Cum. GPA:
Work Experience (Position)
Company
Dates Employed:
Campus Involvement (Name):
Position Held:
Dates of Involvement:
# of Completed
Credits:
PLEASE INDICATE ANY INVOLVEMENTS DURING EMPLOYMENT: Internships, pro-sem, clubs, organizational
meetings, other employment, etc.
Do you have another on campus job?_____ If yes, which department(s)________________________________
PLEASE CHECK the Type of Residence(s) in which you would like to be considered for work as a CA.
Suite: UP
Suite: Dixon
Apartments: South, West
Traditional
Living Learning (Please note):
Housing and Residence Life
New Community Assistant Application
PLEASE RATE YOUR SKILLS SETS on a scale from 1-5 with 5 being Highest
Administrative Skills
Knowledge of KU
Verbal Communication
Time Management
Helping Skills
Diversity
Programming/Event Planning
Written Communication
Creativity
Please answer the following questions
1. How have you demonstrated the skills and competencies that are listed above?
2. What do you consider to be a major personal accomplishment since you arrived at Kutztown
University?
3. Why are community development and programming important functions of the Community Assistant?
4. As a resident in a residential community, please describe how you have enhanced your community.
5. Why are you interested in working as a Community Assistant on the Housing and Residence Life Staff
Team?
I have read the Community Assistant position description and understand the expectations of the position I am
applying for. In the event that I am selected, I will agree to comply with the conditions of employment as a staff
member of Kutztown University’s Housing and Residence Life. I also understand that if I fail to meet these
conditions I will forfeit my position and move to another hall.
NOTE: If hired, this application will remain on file with Housing and Residence Life.
Signature: _______________________________________________Date:_________________________________
Updated: 1/15/2016/MGM