Please Print or Type

Name______Box #______

Campus Address: ______Phone #______

Class Year: ______Cumulative GPA: ______Fall Semester GPA: _____

Male____ Female____ Will you be abroad in 2016-2017? Yes No

Current RA: ______

POE______

Do you plan to be involved in any non-classroom, academic programs during the coming academic year? (ie: student teaching, internship, etc.)? Yes____ No____

If yes, please specify: ______

Which semester? Fall____ Spring____

Estimated time commitment: ______hours per week

Do you have a judicial record at Juniata? YES NO

Please specify______

In which halls have you lived and when? ______

______

______

For office use only:

Date received ______Recom 1 ______Phase #1_____

GPA ______Recom 2 ______Phase #2_____

Judicial Record ______RA ______Phase #3_____

Have you been involved in any co-curricular and/or extra-curricular activities during your time at Juniata College? If so, please list them below; include any offices held:

______

______

______

Please list any co-curricular and/or extra-curricular activities you plan to be involved with during the 2016-2017 academic year:

______

______

______

If selected to be a RA, are there any residence halls in which you would not be comfortable being an RA? If yes, please list and explain why.

______

______

______

Application Process:

Finish and submit this application. After we review your application, you will be contacted and asked to provide the following:

1)  A current resume, with any non-Juniata references, highlighting your campus and community leadership experience.

2)  Two letters of recommendation from Juniata faculty members and/or administrators.

3)  An essay answering the following questions:

o  Why are you interested in an RA position?

o  Please describe what you perceive to be the responsibilities of a RA, and the most difficult challenges of the position.

o  What qualities and personal characteristics do you possess that would make you a good candidate for the RA position?

Please return the application to the Office of Residential Life or email your application to

by Monday November 30th