Dorm Assistant Application

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Name

First Name

Last Name

Phone

(###)

###

####

Gender

Female

Male

What is your current status at FLBC? Student? Graduate? Please give details

Reference #1

Please provide references we may call to inquire about your previous employment, volunteer efforts or academic advancement.

Reference #2

Please provide references we may call to inquire about your previous employment, volunteer efforts or academic advancement.

Criminal Background. Have you ever been convicted of a crime?

(Record of convictions will not necessarily be a deterrent to becoming an RA)

Yes

If you answered Yes please describe

Please describe fully the conviction(s) listing the nature of the offense(s), your age at the time of the offense and your rehabilitation since the conviction(s).

Work History

Please give a work history, including details of how long you held the positions and reasons for leaving. You may also submit a resume to info@beyondlimitscollege.com

What motivates you to participate in a program such as Beyond Limits? Please explain the qualities and skills that you feel would enable you to help students with disabilities become more successful (include related training and volunteer experience).

As a Beyond Limits Dorm Assistant you will be working with diverse groups of people, including other FLBC student Dorm Assistants, Beyond Limits Students, and professional staff. Many of these people may come from a different cultural and educational background than your own. What experiences or skills do you possess that prepare you to work effectively within diverse settings?

Being a Beyond Limits Dorm Assistant is an intensive commitment that requires careful attention to safety, schedule details and the ability to help people get along. Please comment on your ability to uphold this commitment in a professional manner.

TERMS OF PARTICIPATION- • Agreement to live alongside, mentor and support up to 6 students with disabilities (with fellow Dorm Assistant) • Agreement to work alongside at least one additional Dorm Assistant. • Adherence to the Free Lutheran Bible College rules, regulations, and code of conduct. • I certify that the information contained in this application is complete and true to the best of my knowledge. • I understand that any misrepresentation or omission of facts will be cause for immediate dismissal. • I agree to attend all training sessions and group meetings conducted by Beyond Limits leadership • There may be further applications, personal reference checks, interviews, and/or background checks, in order to be matched with a student/client. • I agree to maintain confidentiality with respect to all information I may possess regarding my interactions with Beyond Limits, its students, families and any knowledge of the contents of confidential records. By entering my name below I acknowledge that I have read these terms and am interested in the position of Dorm Assistant.