[REFERENCE FORM]

RESIDENT ASSISTANT APPLICATION

Residence Life Office
2010-2011

This reference form serves the Residence Life Office to select Resident Assistants (RA) for the
2008-2009 academic year.

An RA at RISD is an upper-class student who resides in a residence hall, apartment/loft and

demonstrates leadership by providing advice, developing a community of 20-65 resident students,
or manages the area and students for the apartments/lofts. If you have questions about the
position, you may contact Phil Oliveira, Assistant Director for Residence Life at 401-454-6653 or by
email at poliveir@risd.edu.

The deadline for submission of this form is 4:00 p.m. Friday, January 20, 2010. Please return it to
the Residence Life Office located at 30 Waterman Street, or mail it to Phil Oliveira, Residence Life
Office, RISD, 2 College Street, Providence, RI 02903, or email at poliveir@risd.edu. References
not received by the deadline will render an application incomplete and the candidate
will be ineligible to be considered for a position.

Using the space below or on an attached sheet please provide a candid reference on the following
points.

• Candidate’s ability to relate to people different from themselves

• Candidate’s ability to exercise leadership
• Candidate’s ability to organize themselves and their time management skills
• Candidate’s ability to accept feedback

I AUTHORIZE the Residence Life Office to identify me as the source of this reference and
to release a copy of this reference in its entirety upon request to the applicant.

I DO NOT AUTHORIZE the Residence Life Office to identify me as the source of this
reference, nor do I authorize the release of a copy of this reference in its entirety to the
applicant. I realize that a summary of this reference may be released without my approval.

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Reference Signature Date