Office of Residence Life - Ohio State University



2016-17 PENN PLACE COMMUNITY ADVISOR APPLICATIONPlease complete the following application and attach a resume to assist the Housing Coordinator in assessing your candidacy for the Penn Place Community Advisor. Applications are due no later than Sunday, December 6, 2015 to Jennifer Nelson at nelson.636@osu.edu or 1578 Neil Ave, Columbus OH 43210.PERSONAL INFORMATIONName (last, first, middle) : FORMTEXT ?????Email Address: Cell Phone: FORMTEXT ?????Mailing Address: FORMTEXT ?????STUDENT STATUSField of Study, Enrolled College or Major: FORMTEXT FORMTEXT ?????Undergraduate degree (if received):Expected OSU Graduation Date: FORMTEXT ?????Current Status (Undergrad, Graduate, Professional):Cumulative GPA:Are you legally eligible to work in the United States? Yes FORMCHECKBOX No FORMCHECKBOX Will you now or in the future need Visa sponsorship for employment? Yes FORMCHECKBOX No FORMCHECKBOX Employment History(Please list your two most recent jobs)Employer: FORMTEXT Dates Employed: FORMTEXT ?????Position/Title: FORMTEXT ?????Address: FORMTEXT ?????Job Responsibilities:Employer: FORMTEXT Dates Employed: FORMTEXT ?????Position/Title: FORMTEXT ?????Address: FORMTEXT ?????Job Responsibilities:Relevant ExperienceList any experience or other organizational work that you consider to be relevant to your ability to perform this job:References(Please provide at least two references that we may contact)Name: FORMTEXT Position: FORMTEXT ?????Phone number: FORMTEXT ?????email: FORMTEXT ?????Name: FORMTEXT Position: FORMTEXT ?????Phone number: FORMTEXT ?????email: FORMTEXT ?????Name: FORMTEXT Position: FORMTEXT ?????Phone number: FORMTEXT ?????email: FORMTEXT ?????Additional Questions(Please attach your answers and a resume)Why are you interested in being the Penn Place Community Advisor?Describe any personal or professional experience and/or qualities, such as event planning, community development or crisis response, which you feel qualify you for this position. How will these experiences aid you as the Penn Place Community Advisor?What do you believe are some unique needs of students in recovery and what would you do to address those needs?Knowing that some of the residents living in Penn Place may be in recovery from drug or alcohol addiction, may be allies or non-recovery students, please describe some approaches you would take to building community.I certify the answers on this document are true, to the best of my knowledge. I realize all the information furnished about myself will be verified by The Ohio State University and that any misrepresentation of facts may constitute cause for discontinuance in the selection process, a non-appointment or dismissal. I authorize all previous employers to cooperate with the University and to release, on a confidential basis any information concerning my employment, and further authorize University Housing access to my academic records and Student Conduct records. I have read and am familiar with the position description and the terms of employment. I agree to abide by all University and University Housing regulations. __________________________________________ FORMTEXT ?????_____________Signature of Applicant Date The Ohio State University is an Equal Opportunity/Affirmative Action Employer.Qualified women, minorities, Vietnam-era veterans, disabled veterans and individuals with disabilities are encouraged to apply. ................
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