Applicant Information

Buc Guide Application 2016-2017

Full Name: E #: Last First M.I.

Campus Address: Residence Hall/Apartment Complex Room Number

If currently residing off-campus, your address

Cell phone #: Goldmail :

Anticipated Graduatio Fall 2015 GPA: Cumulative GPA.: n Date:

Dates you have lived on-campus:

Have you ever been subject to disciplinary action from the Department of Housing and Residence Life, Division of Student Affairs, YES NO YES NO or any academic unit/department at ETSU? Are you encumbered for any reason at ETSU?

If yes, please specify University/ Have you ever attended another college or YES NO College and University? dates

Have you ever been charged or convicted YES NO of a felony or misdemeanor?

If yes, explain:

References, including current supervisors, former supervisors, advisors, etc. Please do not include family members. Please list two references.

Full Name: Relationship: Company: Phone: Address: ______Email: ______

Full Name: Relationship: Company: Phone: Address: ______Email: ______Application Questions

1. Why are you interested in becoming a Buc Guide and what role(s) do you believe you would play in helping students transition to East Tennessee State University? 2. Describe the approach you would take to connect with students in the community who do not think they need your help or are resistant to the idea of having a Buc Guide. 3. Please describe the style of leadership you most-often take and how you would bring this role to the Buc Guide position. 4. What do you believe are the challenges that you may face as a Buc Guide?

Additional Employment and Leadership

Please list any employment or leadership positions that you will hold from fall 2016 through spring 2017. Include the name of the office or department, and the approximate time commitment per week.

Disclaimer and Signature

By indicating "yes" below, I direct the Division of Student Affairs, the Department of Housing and Residence Life, and any other applicable programs to release my student behavior and conduct records, to staff members in the Department of Housing and Residence Life. I further consent to the Department of Housing and Residence Life verifying my academic GPA. I understand that the Department of Housing and Residence Life will be reviewing my online profile (Facebook, Twitter, Pinterest, etc.) when evaluating my suitability for employment.

I understand that if any information in my application is found to be false, my application will no longer be considered.

Signature: Date:______