New Resident Assistant Application
For the 2016-2017 Academic Year
Office of Residential Life and Education
APPLICANT INFORMATION
Name:
Date of birth:
ID Number:
Phone:
Current Campus Address
Hall:
Room Number:
Permanent Address
City:
State:
ZIP Code:
Year of Graduation:
Major:
Minor:
Fall 2015 Semester GPA:
Overall GPA:
Tshirt Size (S-XXL):
Jacket Size: (S-XXL)
Do you have/will you have a vehicle you plan to bring to campus for the 2016 -2017 Academic Year? (Yes or No):
LIFE AT SAINT ANSELM COLLEGE
Have you lived in Saint Anselm College’s Residence halls ? (Yes or No):
If Yes:
Which Building:
How Many Semesters:
Have you lived in Saint Anselm College’s Residential Apartments? (Yes or No):
Which Building:
How Many semesters:
Do you have any other community living experiences? (Prep School, etc. Yes or No):
Please explain your involvement with other community living experiences:
If you are hired and your placement requires you to have roommates or one roommate who would your roommate(s)
be?
Roommate Name(s)
Year of Graduation
LEADERSHIP EXPERIENCE
Please list leadership positions help in clubs, activities, sports, or committees
Leadership Position Held:
Dates Held:
1
Held at Saint Anselm College
(Yes or No):
New Resident Assistant Application
For the 2016-2017 Academic Year
Office of Residential Life and Education
Have you ever worked for the Office of Residential Life and Education Before? (Yes or No) :
If yes, in what capacity:
Please list all work experience you have (Paid, Volunteer, Work -Study, Summer, etc.)
Position Held:
Employer:
Held at Saint Anselm College (Yes or
No):
FURTURE COMMITMENTS
Do you plan to student teach, study abroad, hold a job or an internship, volunteer, participate in Spring/Winter Break
Alternative, participate in a sport, ROTC, or other campus group, during the Academic Year? (Yes or No):
If yes, please explain the time commitment(s) you will need to balance:
REFERENCES
Please identify three individuals who will be submitting reference forms for you.
Name:
Address:
Phone:
Relationship:
CANDIDATE RELEASE:
I, ___________________, grant the office of Residential Life and Education permission to verify my judicial standing, academi c
standing, and financial standing with Saint Anselm College. I understand that this information will only be used by the Resid ent
Assistant Selection Committee and will not be share with any other individuals.
This release must be electronically signed in order to continue through the process.
Please type your entire name here to sign ->
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New Resident Assistant Application
For the 2016-2017 Academic Year
Office of Residential Life and Education
My signature further indicated that:
1. I possess the minimum qualifications required for this position as specified in this packet.
2. I have read the RA application Packet and understand the requirements of the RA position
3. I understand that I will not have the opportunity to personally review or inspect any selection process documents once
completed.
4. To the best of my knowledge, all information on this application is accurate. Any misrepresentation may cause my
application to be rejected, my name to be removed from the eligible pool of candidate s, and/or subject to terminiation
from employment by the Office of Residential Life and Education.
Please type your entire name here to sign ->
Account no.
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