HousingApp

Last Name

First Name

Student ID #

Year Applying

Gender

Male

Female

School/Program/Affiliation

Year (1st - 2nd - etc)

Home phone #

Cell phone #:

Local/Billing Address

City/State/Zip code

Apartment Preference

1 bedroom (12 month contract)

2 bedroom

4 bedroom

Top Preference

1 bedroom

2 bedroom

4 bedroom

I am:

a smoker

a non-smoker

I am allergic to:

My hobbies are:

Activities I participate in:

I prefer to study:

Morning

Afternoon

Evening

Late night

While studying TV/radio is:

On

Off

I am:

very neat

moderately neat

somewhat cluttered

I am:

an early riser

a late riser

Potential roommate(s)

Other Information