Housing and Residence Life Returning Community Assistant Application CANDIDATE INFORMATION Semester Applying For: Please Select Last Name: First Name: Date of Birth: Middle Initial: Permanent Address: On Campus Address: Room Hall Please Select 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: @live.kutztown.edu # of Completed Credits: PLEASE INDICATE ANY INVOLVEMENTS DURING EMPLOYMENT: Internships, pro-sem, clubs, organizational meetings, other employment, etc. Do you have another job on campus? Select 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 Returning 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 SelectTime Management SelectHelping Skills SelectDiversity Programming/Event Planning 1-Lowest SelectWritten Communication SelectCreativity Select 1-Lowest Select Please answer the following questions 1. What is the greatest factor guiding your interest in continuing to serves as a Community Assistant? 2. What do you feel have been your most successful accomplishments as a Community Assistant? 3. As a returning Community Assistant, what would you hope to accomplish by being on staff again? Accomplish for yourself? Accomplish for the team? 4. What area or area(s) would you like to have more focused training? 5. What has been your biggest challenge thus far and how have you dealt with it? 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. If hired, this application will remain on file with Housing and Residence Life. Type Name:_______________________________________________Date:_________________________________ FINISHED? STOP! PLEASE TAKE A MOMENT TO SAVE YOUR COMPLETED APPLICATION NOW Updated: 1/22/2016/MGM Please PRINT your completed application and bring it to Housing, Residence Life and Dining Services located in 106 Old Main.