Revised 4/14/20 6 | Page
College of the Siskiyous
Student Housing and Residential Life
Recommendation Form for Resident Assistant Candidate 2020-2021
Recommendation Forms are due on or before
May 30
th
6:30pm by email. Late emails will not be considered in
the process. Please submit this form via email fully completed to our office at lodges@siskiyous.edu. DO NOT Cc
or include the candidate on the email submission. This is a confidential form and your recommendation WILL NOT
be shared with the candidate.
Submit via email with the Subject Title as:
RE: (candidate’s first name and last name) Recommendation Form for COS RA 2020-2021.
Candidate’s Name:___________________________________________________________________________
Relationship to Candidate:____________________________________________________________________
Recommenders Contact Phone Number: _______________________________________
PLEASE READ INSTRUCTIONS CAREFULLY: Complete the following section by CIRCLING ONLY ONE (1)
NUMBER that best reflects your judgment on the candidate in that criterion. COMMENTS ARE REQUIRED
pertaining to why you chose that certain number; please note that simply circling a number will not be sufficient
enough to assist us in learning more about the candidate’s potentials or current state. Please feel free to make
additional notes on a separate attached sheet.
1 = Never 2 = Seldom 3 = Sometimes 4 = Frequently 5 = Always NA = Not Able to
Judge
The Candidate:
1. Has a genuine concern for other people’s needs
. 1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
2. Would be able to enforce college policies fairly
. 1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
3. Demonstrates leadership with other members, coworkers
/ 1 2 3 4 5 NA
other students.
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Revised 4/14/20 7 | Page
4. Participates actively and genuinely in whatever they are
1 2 3 4 5 NA
taking part in or a apart of.
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
5. Has the ability to deal with conflicts which could arise on
1 2 3 4 5 NA
the floor.
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
6. Appears to be confident in their abilities when performing
1 2 3 4 5 NA
tasks or assignments.
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
7. Displays the ability to be flexible or adaptive to change.
1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
8. Displays the ability to work independently.
1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
9. Demonstrates the ability to cooperate well in groups
. 1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
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10. Appears to be open-minded and sensitive to people’s 1 2 3 4 5 NA
differences and views.
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
11. Demonstrates creativity and/or out of the box thinking.
1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
12. Appears to be motivated or takes initiatives with tasks.
1 2 3 4 5 NA
Comments:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
13.
Please make additional comments of your overall evaluation of this candidate’s potential to be
successful in the Resident Assistant position and why we should employ this candidate.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Please check off ONE (1) of the recommendations:
I, the recommender,
[ ] highly recommend [ ] recommend [ ] cannot recommend
this candidate for the Resident Assistant position.
By signing this form I verify that all of the information provided is correct and factual to the best of my
knowledge. We appreciate you taking the time write a strong recommendation for this candidate, the
information you have provided will help us make our decision.
Recommender’s Printed Name:__________________________________________
Recommenders Signature: _____________________________________________ Date: ____________
STAFF FILL IN ONLY: Received Date: _______________ Complete: YES
NO
Staff Initial: ________
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