I DON'T HAVE A ROOMMATE!

Your answers will be used, if necessary, to match you with a potential roommate. Please be as honest and accurate as possible. Failure to complete this form does not mean that you can keep your room as a single—it only means that we will not be able to take your preferences into account if we need to match you with a roommate.

Please see Student Handbook: "If a student resides in an 'open double' a double occupancy room with one occupant, she should expect to receive a roommate at any point during the semester. The college reserves the right to request students in an 'open double' to consolidate with other students in the same situation in order to create space for students needing housing. It is imperative that ample space remain available for the new roommate. This includes but is not limited to her own desk, dresser, bed, closet space and wall space. The college feels strongly that intentionally discouraging a potential roommate through any means is a violation of a respectful community environment and will not be tolerated. Students engaging in such behavior should expect to meet with their area coordinator and/or the associate dean for student affairs."

Name

ID

House

Cutter/Center Campus Gawith/Center Campus Haven-Wesley/Center Campus Hopkins/Center Campus Park Complex/Center Campus Sessions Complex/Center Campus Tenney/Center Campus Ziskind/Center Campus 44 Green/Green Street 54 Green/Green Street 47 Belmont/Green Street Chapin/Green Street Hubbard/Green Street Lawrence/Green Street Morris/Green Street Tyler/Green Street Washburn/Green Street Comstock/West Quad Gardiner/West Quad Morrow/West Quad Wilder/West Quad Wilson/West Quad Cushing/East Quad Emerson/East Quad Jordan/East Quad King/East Quad Scales/East Quad Capen/Upper Elm Dawes/Upper Elm Lamont/Upper Elm Northrop/Upper Elm Parsons Complex/Upper Elm Talbot/Upper Elm 150 Elm/Lower Elm 12/26 Bedford/Lower Elm Albright/Lower Elm Baldwin/Lower Elm Chase/Lower Elm Conway/Lower Elm Duckett/Lower Elm Gillett/Lower Elm

Room

Extension

Box

Email

I am a

Nonsmoker Smoker

I reguarly go to bed

Before 11 p.m. Between 11 p.m. and 1 a.m. After 1 a.m. No preference

Are you on a sports team?

Yes No

What time do you wake up in the morning?

I am a

Morning person Night person

I expect to regularly receive phone calls (check which apply):

After 11 p.m. Before 8 a.m.

How much privacy do you need?

Much Some Little

I prefer my room to be kept

Neat Messy No preference

When studying, I

Do not like to play music Enjoy music

I prefer to study

In my room In the library In an academic building

What type of music do you prefer?

Country/Western

Yes No No preference

Folk	Yes No No preference

Rap	Yes No No preference

Jazz	Yes No No preference

Pop	Yes No No preference

Alternative

Yes No No preference

Hard rock

Yes No No preference

Religious

Yes No No preference

Ska	Yes No No preference

Classical

Yes No No preference

World Beat

Yes No No preference

Show Tunes

Yes No No preference

I would mind a roommate having (check all that apply)

Friends overnight A significant other

I prefer a roommate who is substance free (no tobacco, alcohol, etc.)

Yes No preference

Which three items should we be most concerned about when arranging your roommate assignment?

Please share any additional information that you believe would be helpful in assigning you a roommate

Please print a copy of this form for your own records before you submit it