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Resident Assistant Reference Form

The Resident Assistant (RA) position is central to the success of the Residence Life program at Averett University. It is designed to aid students in their educational and social development through community workshops, enforcement of community standards, conflict mediation and fostering a living and learning environment. The RA position is crucial in the development of the residential community. Staff members must be able to balance academics, extracurricular activities and this leadership position in a healthy way. You have been asked to comment on this particular candidate's skills and qualifications for the position. Please do not hesitate to be candid.

Personal Information
Applicant's First Name
Applicant's Last Name
Applicant's reference #(applicant should provide)
Your Name
E-mail Address
Phone #
Are you affiliated with Averett University?
Yes No
If so, how?

What is your relationship with the applicant?

How long have you known the applicant?

Applicant Evaluation

Please rate the candidate on the following skills that relate to the Resident Assistant position.
5=excellent 4=Above Average 3=Average 2=Below Average 1=Poor Blank=Unknown

Communication Skills 1 2 3 4 5
Interpersonal Skills 1 2 3 4 5
Conflict Management Skills 1 2 3 4 5
Time Management Skills 1 2 3 4 5
Acceptance of Others 1 2 3 4 5
Reliability 1 2 3 4 5
Ability to Relate with Peers 1 2 3 4 5
Leadership Ability 1 2 3 4 5

Please use this space to elaborate on any of the above questions or provide anything else that you feel would help us more clearly see the ability or character of the candidate.

Please type AVERETT in the box.

Thank you for your time; your input is appreciated. You should receive an e-mail confirming your submission.


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