Resident Assistant Reference Form

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Resident Assistant Reference Form
The following form is used by the Office of Residence Life and Housing to assist us in the
assessment of potential resident assistant candidates. The form must be filled out completely. We
have given rating criteria for you to use, as well as a comments area. This form must be used in this
process, letters of recommendation cannot be accepted.
Name of Applicant:
_____________________________________________________________________
Name of Reference:
_____________________________________________________________________
Relationship to Applicant:
________________________________________________________________
How long have you known the reference:
____________________________________________________
__ I waive my right to view this reference in the future
__I retain my right to view this reference in the future
______________________________________________________________ _____________
Signature of Applicant
Date
Please rate the candidate on the following scale as it relates to the following statements:
NA
1
2
3
4
5
Cannot Answer
Poor
Average
Excellent
resident assistants must be able to work with a wide range of people and be accepting of diverse
values, morals, and lifestyles. Please rate this applicant on their ability to work with, and mentor, a
diverse population.
Rating: _____
Comments:
resident assistants are given responsibilities to assume a number of important tasks: building
security, contacting persons for emergencies, getting information to residents, and general customer
service functions. Please rate the applicant on their ability to assume high levels of responsibilities,
with or with out supervision.
Rating: _____
Comments:
resident assistants must demonstrate good time management skills and balance job responsibilities,
schoolwork, and personal commitments. Please rate the applicant on their time management skills.
Rating: ____
Comments:
resident assistants serve para-professional mentors and leaders to individuals on academic, personal
and general issues. Good listening skills and personal stability are essential. Please rate the applicant
on their ability to serve as a mentor and leader. Rating: ____
Comments:
resident assistants are key role models for other students on campus. Please rate this applicant on
how you view them as a role model.
Rating: _____
Comments:
resident assistants must often deal with conflict between individuals and groups. Please rate this
applicant on their ability to deal with conflict, and their willingness and ability to confront inappropriate
behavior.
Rating: _____
Comments:
resident assistants must be able to lead and facilitate group meetings and organize events. Please
rate this applicant on their group facilitation skills.
Rating: _____
Comments:
If you had the ability to hire or rehire this applicant, would you? Yes
circled no)
No (please explain if you
Other comments that would assist the Selection Committee in making this decision:
_________________________________________________
Printed Name
_________
Date
_________________________________________________
Signature
_________
Date
Return completed references to Monarch or La Plata Front
Desk by March 21st, 2016 at 4pm. No exceptions.
Questions? Contact Donald Wynn dwynn@uccs.edu or Molly
Kinne mkinne2@uccs.edu
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