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Resident Assistant Application

General Information
I AM APPLYING FOR:
Name (Last)
Name (First)
Name (MI)
Gender

Current Address
Street Address
Apartment/Unit
City
State
Zip
Phone (Incl. Area Code)
EMail

Permanent Address
Street Address
Apartment/Unit
City
State
Zip
Phone (Incl. Area Code)

Academic Information

University Housing Information
Have you ever lived in any institution's University Housing?

No (skip to next section)

Yes (see additional questions)

If at Wright State University, please list the date(s) and location(s)
If at another university or college, please indicate the institution and what type of housing you were assigned (i.e. first year student hall, living learning community, upper class hall, campus apartments theme housing, etc..

Specialized Group Housing

I am interested in Special Interest Housing (check all that apply)


Work Related Experience
Please list your last three positions of employment
Place of Employment (1)
Dates of Employment
Position Title
Reason for Leaving
Brief Description of Job Duties:
Supervisor Name
Phone
The Office of Residence Services reserves the right to contact previous employers for employment verification and job references
Place of Employment (2)
Dates of Employment
Position Title
Reason for Leaving
Brief Description of Job Duties:
Supervisor Name
Phone
The Office of Residence Services reserves the right to contact previous employers for employment verification and job references
Place of Employment (3)
Dates of Employment
Position Title
Reason for Leaving
Brief Description of Job Duties:
Supervisor Name
Phone
The Office of Residence Services reserves the right to contact previous employers for employment verification and job references

Leadership Experience / Involvement in Co-Curricular Activities
Please list any organizations or leadership roles you have participated in at Wright State University or elsewhere.  Please choose the activities most closely related to the position for which you are applying.
Organization (1)
Leadership Role/Position
Dates of Involvement
Institution
Organization (2)
Leadership Role/Position
Dates of Involvement
Institution
Organization (3)
Leadership Role/Position
Dates of Involvement
Institution
Organization (4)
Leadership Role/Position
Dates of Involvement
Institution

Other (REQUIRED)

Why do you want to be an RA?


Please share any other details you feel are pertinent to this application.

Please be aware that spelling and grammatical errors reflect poorly on a candidate.  Be sure to proof read this application.

I understand that by clicking  ‘Submit Form’, I authorize the Office of Residence Services to initiate a criminal background check to be used solely for employment-related purposes.

3640 Colonel Glenn Highway - Dayton, Ohio - 45435
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Last updated: Wed. Feb-26-14, 15:11
Please send comments to: housing@wright.edu
Wright State University