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Prospective Resident Assistant Candidate Reference Form 2020-2021

Thank you for providing a reference for a student applying to become a Resident Assistant for the 2020-21 academic year.

It is recommended that all references for RA candidates must be members of the on-campus Brockport faculty or professional staff. Resident Directors and current Resident Assistants are NOT eligible to provide references. Family members are not able to provide references.

Please complete all the provided areas to provide the best reference for the student. If you have any questions or concerns, please feel free to email the Residential Life RA Search Committee at RASelect@Brockport.edu.

For additional information on the RA Selection process, visit www.brockport.edu/reslife/ra_apply.

All references will be due by Wednesday, February 12, 2020 at 11:59 PM.

  • Candidate Name Candidate Name *
  • Reference Contact Information

  • Your Name Your Name *
  • The College at Brockport Faculty/Staff only.

  • Phone Number: Phone Number: * - -
  • Reference Information

  • The areas listed in the chart below are skill sets that are integral to the Resident Assistant position. Please evaluate the candidate’s abilities in comparison to his/her peers. *
    The areas listed in the chart below are skill sets that are integral to the Resident Assistant position. Please evaluate the candidate’s abilities in comparison to his/her peers. Poor Developing Satisfactory Excellent Don't Know
    Ability to Serve as a Role Model
    Ability to Serve as a Role Model
    Ability to Serve as a Role Model
    Ability to Serve as a Role Model
    Ability to Serve as a Role Model
    Ability to Serve as a Role Model
    Ability to Communicate
    Ability to Communicate
    Ability to Communicate
    Ability to Communicate
    Ability to Communicate
    Ability to Communicate
    Ability to Receive Feedback
    Ability to Receive Feedback
    Ability to Receive Feedback
    Ability to Receive Feedback
    Ability to Receive Feedback
    Ability to Receive Feedback
    Critical Thinking Skills
    Critical Thinking Skills
    Critical Thinking Skills
    Critical Thinking Skills
    Critical Thinking Skills
    Critical Thinking Skills
    Ability to Listen
    Ability to Listen
    Ability to Listen
    Ability to Listen
    Ability to Listen
    Ability to Listen
    Diversity & Social Justice Awareness
    Diversity & Social Justice Awareness
    Diversity & Social Justice Awareness
    Diversity & Social Justice Awareness
    Diversity & Social Justice Awareness
    Diversity & Social Justice Awareness
    Ability to Work in a Group/Team
    Ability to Work in a Group/Team
    Ability to Work in a Group/Team
    Ability to Work in a Group/Team
    Ability to Work in a Group/Team
    Ability to Work in a Group/Team
    Ability to Respond to a Conflict
    Ability to Respond to a Conflict
    Ability to Respond to a Conflict
    Ability to Respond to a Conflict
    Ability to Respond to a Conflict
    Ability to Respond to a Conflict
    Self-Awareness
    Self-Awareness
    Self-Awareness
    Self-Awareness
    Self-Awareness
    Self-Awareness
    Resilience
    Resilience
    Resilience
    Resilience
    Resilience
    Resilience
  • Do you: *
    Do you:
  • Draw or Type
    I understand this is a legal representation of my signature. Clear
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