Prospective Resident Advisor Form

 

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Please fill out this form and submit it to the Trinidad State Housing Department

 

Fields marked with a   Θ  are required

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Enter Full Name -

Θ  First:

Θ  Last:

General Information:
Θ  Home Phone:
Θ  Email Address:
Θ  Confirm Email Address:
Address:
Θ  Street:
Θ  City:
Θ  State:	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Θ  Zip:

Other Information:
Date of Birth
Marital Status
When will you be available for employment?	Semester: Year:
Classification for semester applying	Choose One Freshman Sophomore Third Year
Have you lived in the dorms before?	Yes No
Intended Plan of Study:

Other Information:
Last Semester GPA:
Cumulative GPA:
Credits Earned:

Qualifications:
Please list any activities that you think have prepared you to be a dorm assistant: