2012-2013 Staff RA Selection Application Form

Background Information

Last Name:
First Name:
Sex:  Male   Female 
ID #
You are a:  Commuter     Resident
Current Address:
City:
State:
ZIP:
Campus Phone:
Cell Phone:
Permanent Address (if different from your current address):
City:
State/Province:
ZIP/Postal Code:
Permanent Phone:
Date of Birth:
Academic Major:
GPA:
Expected Graduation Year:
E-mail address:
How did you hear about RA selection?

Current Information

Please list your interests, hobbies, Canisius College clubs/activities and previous work experiences (max 500 words):
 
Please list any leadership positions you currently hold or have held (include dates) (max 500 words):
 
Please list any honors and/or awards that you have received (max 500 words):

Placement

List three placement choices in rank order.  Please understand that your choices will be considered, but ultimately we will place you where your skills will be used most effectively.



Group Interview Process

You are required to attend one of the following group interview process sessions in January. Group process is the first part of the two part interview process for RA Selection. The group process involves four group activities that will allow you to show your team work skills and your personal leadership style. You can dress casually for this event. Group process will be in the Richard E. Winter '42 Student Center.

Please check which day(s) you are available to attend group process:
*Note: Applicants are required to attend one of the two group process sessions. If you are able to attend either date, please select both options as both sessions will be capped. You will be notified at the end of the application process via e-mail as to which session you are assigned.
 Saturday, January 21, 2012, 1:00pm-4:00 pm  
 Thursday, January 26, 2012, 6:00pm-9:00pm 

References

Please have three people fill out a recommendation form at www.canisius.edu/reslife/rareference.asp by December 9, 2011 at 5:00pm.  One recommendation should be from a work supervisor, one from a Canisius College faculty or staff member, and one from a peer.  Please note that current Resident Assistants (2011-2012) may only be used as the peer recommendation. 

Please list your references.
1) Name:    
Phone: 
Title:
Type of reference:
2) Name:
Phone: 
Title:
Type of reference:
3) Name:
Phone: 
Title:
Type of reference:
 

By clicking the submit button, you are certifying that all of the above information is true.