Fillable Resident-Assistant-Application-template View Survey

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Resident-Assistant-Application-template View Survey

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Resident Assistant Application 2019-2020
1. First Name:*
2. Middle Name:
3. Last Name:*
4. TWU ID:*
MM/DD/YYYY
Date
5. Date of Birth:*
6. Your Pioneer Portal email address:*
7. Please provide a phone number at which you can be reached:*
Residence Hall/ Apartment
Room/Apartment Number
8. Campus Address:*
1
Resident Assistant Application 2019-2020
9. At the end of the Spring 2019 semester, how many semesters will you have lived on campus?*
10. Classification at the end of the Spring 2019 semester*
Freshman (0-29 credit hours completed)
Sophomore (30-59 credit hours completed)
Junior (60-89 credit hours completed)
Senior (90+ credit hours completed)
Graduate (enrolled in graduate level courses)
11. Anticipated Graduation Date (Please specify term and year):*
12. Academic Major:*
College/University
City, State
Year(s) Attended
13. If you have attended another college or university, please list the institution below:
14. Will your curriculum take you to a TWU center campus (i.e. Houston or Dallas) during the 2019-2020
academic year?
*
15. If you answered yes, when? Please list semester and year:
16. Have you ever been employed at TWU?*
2
Department
Position
Dates of employment
Supervisor
17. If yes, please list the following:
Department
Position
Dates of employment
Supervisor
18. If yes, please list the following:
Department
Position
Dates of employment
Supervisor
19. If yes, please list the following:
20. Were you a member of a TWU Living Learning Community?*
21. If yes, please indicate which Living Learning Community you were a member of:
22. What term and year were you a member of a Living Learning Community?
3
23. Please list campus organizations and leadership/service opportunities in which you are currently
involved:
*
4
Resident Assistant Application 2019-2020
24. Have you ever been convicted of a crime over the age of 18?*
25. If yes, please explain:
26. Have you ever been subject to disciplinary action as a result of a Student Code of Conduct violation or
as a result of an infraction of a University Housing & Residence Life policy?
*
27. If yes, please explain:
5
Resident Assistant Application 2019-2020
28. What will you contribute to the Resident Assistant position and what benefits do you think you will gain
from serving in this capacity?
*
29. What is your definition of leadership and how have you been an example of this during your time at
TWU?
*
6
Resident Assistant Application 2019-2020
The position you have applied for is a security sensitive position. A security check may be conducted on each applicant considered for
employment.
State law (Leg. House Bill 1922) with limited exceptions, allows you to be informed about information the University collects about you,
to review, and obtain the information on this form and to correct any information you believe is incorrect. Disclosure of your social
security number (SSN) is required as a unique number to identify you at TWU. Any further disclosure of your SSN will be governed by
The Public Info. Act (Chapter 552 of the Texas Govt. Code).
In order to ensure the accuracy and fairness for all candidates, the information you provided in this application will be verified. By
agreeing to the following statements you are granting the Department of University Housing & Residence Life permission to verify your
academic and judicial standing at Texas Woman’s University. This information is used by the professional staff directly responsible for
hiring only and is not shared with any other individuals.
I agree that
· I have read the Resident Assistant position description and I understand that the position requires a weekly commitment of
approximately 20 hours and the ability to attend training before the start of classes before Fall (mid August) and Spring (early January).
· I understand that I do not have a position at any point in the selection process until I am offered a Resident Assistant Employment
Agreement in writing.
· To the best of my knowledge, all information on this application is accurate. Any misrepresentation may cause my application to
be rejected; and/or my name removed from the pool of candidates.
30. I agree to the release stated above.*
7
Resident Assistant Application 2019-2020
Thank you for applying for the Resident Assistant position. More information will be forthcoming through your Pioneer Portal e-mail
account.
If after reviewing the information contained on the housing website pertaining to applicants, you have questions , please e-mail Vik
Arunkumar at varunkumar@twu.edu
8
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Completed 4 January 2020

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