Personal Data
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| Last name: |
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| First name: |
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| Middle name: |
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| SAIC Email: |
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| Current Address: |
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| Phone Number: |
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| Alternate phone number: |
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| Alternate email: |
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SAIC is committed to creating a diverse community of faculty and students, and is an Equal Opportunity Employer. Applicants are considered on the basis of their qualifications for the position without discrimination on the basis of race, color, gender, religion, national origin, disability, age, sexual orientation, gender-related identity, marital status, parental status, military or formal military status, and any other basis prohibited by applicable federal, state, or local law.
The following section is optional and will be used for the sole purpose of collecting data on the diversity of our applicant pool.
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| Are you an international or domestic student: |
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| Ethnicity (As defined by the 2010 US Census Bureau): |
Other: |
| Gender: |
Other: |
| Do you currently live on or off campus? |
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School Experience
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| How many years have you spent at SAIC: |
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| What is your current status: |
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| Focus: |
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| Credits Completed by May 2013: |
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| Expected Graduation Date: |
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| Were you a tranfer student to SAIC? |
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| Are planning to participate in any of the following during the 2013-2014 academic year? |
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| Residence Hall Living Experience |
| Semester/Year: |
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| Hall: |
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| School: |
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| Semester/Year: |
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| Hall: |
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| School: |
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| Other College Attended |
| Name: |
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| Location: |
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| Degrees: |
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| Name: |
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| Location: |
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| Degrees: |
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Building Preference
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| Please explain your building preference |
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| Please note: Residence Life attempts to accommodate placement requests, but makes staff room, floor and building assignments based on what best serves the needs of the entire residential community. |
References
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In order to complete this portion of the application process you will need to first select two people who will act as your references. Once you have done so, e-mail the following reference form link (http://www.saic.edu/forms/life/residentadvisorapplication-reference) to both of your references. You must have two reference forms submitted in order to have a complete application file. The reference form link that you send to your references will feed into a Google Document, so there is no need to submit this information via email or by mail. It is your responsibility to make sure that your references submit the reference form by noon on December 21, 2012. An applicant without reference forms on file will not be considered a viable candidate.
In accordance with the provisions of the Federal Educational Rights and Privacy Act of 1974, enrolled students have the right to see their letters of recommendation unless they explicitly waive that right. Please note that if you request to review this form, the evaluator’s name will be withheld.
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| References |
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| Please provide the reference form link to two references and list their names here. Please include at least one reference from an SAIC faculty member, staff member or current Resident Advisor. Note: It is not advisable to have a family member complete a reference form. |
| Name of reference: |
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| Phone: |
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| Email |
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| Relationship to applicant: |
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| Name of reference: |
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| Phone: |
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| Email: |
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| Relationship to applicant: |
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Self Evaluation
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| Why are you interested in the Resident Advisor position? |
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| What personal or professional experiences have prepared you for this position? |
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| What do you perceive to be the primary responsibilities of this position? |
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| Which part of the position would be the most challenging for you? How do you anticipate addressing these challenges? |
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| Which part of the position would you excel at? |
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| What does community mean to you? What role do you think RAs play in developing community at SAIC? |
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