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Housing & Roommate Preference Form

First Name
Middle Name
Last Name
Nickname
Birth date (month/day/year)	/ /
Gender	Male Female
E-mail
Parent's e-mail
Home Phone
Student's cell
Father's name
Mother's name
Home address
City
State
Zip
High School
Intended Major

Check One:
I plan to live in on-campus housing. I plan to commute from the address listed above.
Check One:
My deposit was previously sent to Admissions. My deposit is on its way. ($100 for commuter students; $250 for resident students)

Roommate Preference Information
Roommate assignments are made based on the following information. Residence hall assignments are then made based on the earliest confirmation date between you and your roommate(s)
Do you have a roommate preference? If yes, please list their name here: Please note that they must also indicate a desire to room with you on their form.
Do you have a residence hall preference? If yes, please list here: Due to space limitations, preference is not guaranteed. We strive to place freshman in freshman residence halls.

Please select one response in each of the following questions:
Which statement best describes you? I usually go to bed before midnight on weekdays. I usually go to bed after midnight on weekdays.
Which statement best describes you? I prefer to wake up early in the morning. I prefer to sleep until mid-morning. I prefer to sleep as late as I can.
Which best describes you? I prefer to study late at night. I prefer to study in the early evening. I prefer to study in the late afternoon.
Which best describes you? I tend to follow a strict study and recreation schedule. I schedule my study time only. I am spontaneous with my studies and recreation.
Which statement best describes your bedroom at home? Immaculate Generally neat and tidy Generally cluttered
How do you feel about your roommate borrowing your personal belongings (clothes, food, toiletries...)? I would not mind at all. I would mind a great deal. I have no opinion.

When assigning a roommate, what should we consider as most important to you? Please number 1-7, 1 is most important and 7 is least important.
Academic major
Sleep Habits
Christian commitment
Music preference	What style?
Student activities	Which activity?
Sports involvement	Which sport?
Other	Please explain.

From the following list, please check if you participated in high school and/or if you plan to in college.
	High School	College
Student Activities
Band
Big Brothers/Big Sisters
Chess Club
Choir
Debate
Habitat for Humanity
Intramural sports
Newspaper
Outdoor Club
Theatre
SADD
Student government
Youth Group
Yearbook
Sporting Activities
Baseball
Basketball
Camping
Cross Country
Fishing
Football
Hiking
Hockey
Hunting
Skiing
Softball
Soccer
Swimming
Tennis
Trainer
Track
Water sports
Weightlifting
Wrestling
General Interest
Art
Cars
Computers
Biking
Dance
Languages
Mission trips
Music
Reading
Television
Travel
Other:
Other:

My favorite kind of music is:
My favorite group or performer is:
My favorite television show is:
In my spare time I like to:
I am the kind of person who enjoys:
The most important thing in life is:
The qualities I look for in a roommate are:
I would be interested in having an international student as a roommate.
Yes No
I have been invited to participate in the Freshman Honors Program and would like to live with another honors student.
Yes No
How many semesters (if any) have you already completed at a previous institution?

Optional Question
Please list any physical concerns that may impact your placement in the residence hall.

http://www.geneva.edu/object/forms_housing_roommate.html

Geneva College | 3200 College Ave., Beaver Falls, PA 15010