Housing Questionnaire

Complete the form below to let us know about your interest in and your preferences regarding campus housing. Please note that fields marked in bold are required.
Firstname:
Middlename:
Lastname:
Suffix:
Birth Date:      
Gender:
Email Address:
Home Phone:   -     -      
Cell Phone:   -     -      
Country:
Address:
 
City:
State:
Zip or Postal Code:
If we have questions, how do you prefer that we contact you?
When do you first plan to live on campus?
What do you plan to major in?
(if you aren't sure, pick "Undecided")
Please indicate if there is a specific residence hall and/or floor you are interested in:   

If you indicated a floor preference, please explain why you chose that floor:
If space is available, which of the following would be your preference?


How would you describe your personality?
Would you like to request a specific roommate?
If "Yes," what is that person's name?
Please Note: We cannot guarantee that you will be assigned with your preferred roommate. We will not assign roommate requests until both individuals request each other.
Would you be interested in sharing a room with a student from a country other than the US?
Do you smoke?
Can you live with a smoker?
Do you consider yourself to be a:
Which of these activities do you like to do?












If you chose "Other," list the activities here:
How would you describe your study habits?
Under what conditions do you study most effectively?
List any languages you speak (other than English):
List any countries you have visited:
List or describe activities or interests you have in these areas:
Honors or Extracurricular Activities:
Religious Activities:
Athletic Activities:
List any special needs we need to know about:
Which of these issues is the MOST important to you in determining your room assignment?