UTCID

First Name

Last Name

Gender Male Female

Date of Birth MM/DD/YYYY

 Are you eligible to work in the U.S?
Yes No

 Are you a U.S Resident?
Yes No

Current Status Freshman Sophomore Junior Senior Graduate

Complex, Room #

Home Address

City

State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip

Cell Phone

UTC Email

College Attended 1 Name, Location

Date From & To MM/YY - MM/YY

Anticipated Graduation Date MM/YY

Academic Major

GPA

Honors, Activities, and Organizations

1. Why do you want to be a Resident Assistant?

2. What is the purpose of the RA position?

3. What characteristics make a great RA?

4. What do you consider to be the most pressing problem facing students living in the residence halls at UTC?

5. Indicate your personal skills or interests that you feel may contribute to your being a successful RA.

6. Indicate any outside obligations and extracurricular activities, such as research, student teaching, and clubs or organizations, in which you anticipate being involved with during the coming academic year.

7. Please describe an RA program that you have attended this year and what you learned at the program.

I want to be considered for:
Spring 2012
2012-2013
Both

Please indicate your preferred residence hall community to which you would like to be assigned if you were selected as a Resident Assistant. Please note: This is a preference you will by interviewing for a position in any and all buildings applicable. Check any that apply.

Preference 1
Boling Lockmiller Johnson Obear Guerry (1000) Decosimo (2000) Stophel (3000) Walker (4000) UC Foundation (5000)

Preference 2
Boling Lockmiller Johnson Obear Guerry (1000) Decosimo (2000) Stophel (3000) Walker (4000) UC Foundation (5000)

Preference 3
Boling Lockmiller Johnson Obear Guerry (1000) Decosimo (2000) Stophel (3000) Walker (4000) UC Foundation (5000)

Why did you rank the buildings the way you did?

What are the differences between the needs of upperclassmen students versus the needs of freshmen students?

Provide email addresses of two references. Good references are professors, faculty/staff members, Residence Life Staff (RAs,RDs) or former supervisors/employers. Personal friends and relatives are not good choices for references. We'll send them an email asking for their recommendation of you.

Reference 1 Name

Email

Reference 2 Name

Email

The following statements are intended to cover primary guidelines of employment for residence staff. Please read and check each box next to each statement to indicate your understanding:

Staff members are expected to attend all training sessions (Thursdays 3-5 pm) and other meetings requested by the Housing and Residence Life staff.

Staff members are expected to remain registered as full time students at UTC in good academic standing (2.3 overall and semester GPA).

Staff members are not permitted to take on any off campus employment. All exceptions must be previously approved by the Assistant Director of Residence Life or his/her designee.

I authorize Housing and Residence Life to view my academic and conduct records to verify my GPA and discipline history.

I have read the responsibilities of the Resident Assistant position and meet the necessary qualifications as outlined in the job description.

All applicants MUST print and complete the criminal record and fingerprinting release form.

Please bring this with you when you sign-up for an interview time. You WILL NOT be eligible to sign-up for an interview unless you have turned in the release form. You will receive more information about interview sign-up through your UTC email, please contact Amy-Cabness@utc.edu for any further questions.