MEMBR PROFILE SHEET

Name
                             (First)                           (Middle)                       (Last)

CLASSIFICATION AT TIME OF OCCUPANCY: Fr.   Soph.   Jr.   Sr.    AGE:

SCHOOL ATTENDING AT TIME OF OCCUPANCY:  

FIELD OR MAJOR:      EMAIL ADDRESS:

PRESENT ADDRESS:

PRESENT HOME/CELL PHONE NUMBER:

PERMANENT PHONE NUMBER:

MEMBER OF ANY ORGANIZATION? IF SO, DESCRIBE:

ADDITIONAL PERSONAL PREFERENCES OR CONSIDERATIONS:

If Known, Please List Requested Roommates

1.  Name  Address  Phone #

2.  Name  Address  Phone #

3.  Name  Address  Phone #

4.  Name  Address  Phone #

() Prefer to share with Upper Classman (Junior, Senior, Graduate) only
() I have a television; ( ) use it frequently
() I have a stereo; () use it frequently
() I expect to entertain friends; () of both sexes
() I have a car () motorcycle () bicycle
() I am willing to live in a Co-Ed townhouse

Select One:

Smoke: Yes  No Bothers me if others do
Drink: Yes No Bothers me if others do
Quiet: Yes Average Noisy
Study: Yes Average Seldom
Neat: Yes Average Untidy

Townhouse Preference:     4BR / 2 ½ BA                   5BR / 2 ½ BA

Suite Preference:     2BR / 1 BA                   3BR / 2 BA                   4BR / 2 ½ BA

Three Likes:

Three Dislikes:

OTHER CONSIDERATIONS (Hobbies, Special Interests, Allergies, etc.):

I understand this information will be released to prospective roommates.

Signature                Date

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