RESIDENT ADVISOR APPLICATION
RIDER UNIVERSITY
2010-2011
PLEASE PRINT OR TYPE ALL RESPONSES
Return all forms to:
Lawrenceville Campus: Residence Life Office, Bart Luedeke Center, 1st Floor
Westminster Campus: ADOS Office. C/O Jane Ferrick
by January 24, 2011
RIDER UNIVERSITY IS AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER.
Name ______Preferred Name ______
Bronc ID Number ______
Campus Address: Hall ______Room ______Phone ______
Permanent Address ______Cell-phone ______
ACADEMIC BACKGROUND
Academic Major ______Class Status (please circle): FR SO JR SR
Expected Graduation Date ______Fall Term GPA ______Cumulative GPA ______
Are you a transfer? ______If yes, from where ______GPA ______
RESIDENCE HALL EXPERIENCE
Residence Halls lived in:Lifestyles (single-sex, co-ed, theme):Dates:
______
______
______
Residence Hall Government Residence Hall: Dates:
positions held:
______
______
ACTIVITIES PARTICIPATION
Please list any extracurricular activities in which you have been involved (include offices held and honors or awards received).
Please understand that the RA position is demanding. It is the expectation that this position follows academics in your priority list. List any additional obligations to which you are committed for the up-coming year (Clubs, Organizations, Student Teaching, Internships, Athletic Teams, Major Offices, Part-time Employment, Etc.).
EMPLOYMENT EXPERIENCE
Please list present and previous work experience. Please start with the most current. If you have a resume, please attach it to this application.
Employer/Position: ______Dates: ______
PERSONAL CHARACTERISTICS
What skills and abilities do you possess that would contribute to your performance as a Resident Advisor, and how would you apply these skills to the position?
How do you feel a Resident Advisor position would enhance your own personal and professional development? How does obtaining this role impact your personal/professional goals?
JOB APTITUDE
What aspects of the Resident Advisor job description are you most excited about? What are you least excited about? Why?
Judicial History
Do you have a judicial record? (If yes please answer the questions below, if no, fill in NA (not applicable) and, continue to the next section. Please use a separate sheet if needed.
_____ yes _____ No ______NA
What was the charge? ______
______
______
______
Where you found responsible?
______
______
______
What year/semester did this take place?
______
______
What have you learned from this experience? ______
______
______
______
Letters of Recommendation:
Please list the three individuals you will contact for a recommendation. Please note that at least one of your references
must be from a Rider Faculty or Staff member (not including a current RA staff member). Here are some good examples
for references: professors, advisors, supervisors, mentors.
Name ______Position ______Phone ______
Name ______Position ______Phone ______
Name ______Position ______Phone ______
In accordance with the Family Educational Rights and Privacy Act of 1974:
I hereby ____ agree ____ do not agree (check one) to waive my right of access to information received by the Residence Life Office concerning my candidacy for the Resident Advisor position.
______
SIGNATUREDATE
I understand that this application will be reviewed by Interview Teams. I certify that the information I have submitted is accurate, my own, and the truth to the best of my knowledge. I authorize the release of my academic and disciplinary records for the purpose of verifying my eligibility for this position.
______
SIGNATUREDATE