<p> Lyon College Resident Assistant Reference Form Please return reference form by January 21, 2014</p><p>Part 1 (to be completed by Applicant) Please give this form to three references. Your reference will return the form to Kim Hinds-Brush in Student Life at Lyon College. The references may be from a residence life staff member (RA or Resident Faculty Mentor), college staff member, faculty member, or anyone you feel can be a reference for you with this position but one must be from a current RA. </p><p>Applicant: The Family Educational and Privacy Act of 1974 opened student records for inspection. The law also permits students to sign a waiver relinquishing their rights to see letters of recommendation. Please complete the statement below. </p><p>I ______waive ______do not waive my right to have access to this Personal Reference Form.</p><p>______Applicant Name (Print)</p><p>______Date______Signature of Applicant</p><p>Part 2 Reference (to be completed by reference)</p><p>How long have you known the candidate: ______</p><p>Under what circumstances do you know the candidate: ______</p><p>Considering other college students you know, please rate this candidate according to the following criteria. </p><p>5 – Excellent 4- Above Average 3- Average 2- Has Potential 1- Needs Improvement UN - Unknown</p><p>Leadership 5 4 3 2 1 UN Ability to inspire others Ability to coordinate and lead activities Ability to facilitate a group Organization 5 4 3 2 1 UN Ability to prioritize tasks Ability to manage time wisely Temperament 5 4 3 2 1 UN Ability to maintain a positive outlook Realistic perspective Initiative 5 4 3 2 1 UN How this person approaches new situations Self motivation Ability to set and accomplish goals Ability to work unsupervised Interpersonal Relationships 5 4 3 2 1 UN Appreciation of diversity Attitude and ability to work with others Sincerity Flexibility Cooperation Ability to work with a supervisor Responsibility 5 4 3 2 1 UN Dependable Prompt Communication 5 4 3 2 1 UN Ability to grasp ideas Ability to listen and convey understanding to others Maturity 5 4 3 2 1 UN Ability to deal with a wide range of personalities Common sense, judgment Emotional Stability 5 4 3 2 1 UN Direction and control of emotional response Social sensitivity 5 4 3 2 1 UN Ability to be sensitive to and understand the feelings and reactions of others Ability to effectively respond to difficult situations</p><p>Additional Comments</p><p>Signature of reference Date</p><p>Print name of reference Phone number or email address</p><p>Please return this reference to: Lyon College, Department of Residence Life Kim Hinds-Brush 2300 Highland Rd. Batesville, AR 72501 Phone 870-307-7375 Email [email protected]</p>