Student Housing Questionaire

Please complete the following set of questions to assist our office in making housing and roommate assignments for the upcoming academic year.  Housing assignments are determined by the date you pay your deposit to the University.  If you have additional questions about residence life, please do not hesitate to contact Betsi Werling, director of residence life at 419-358-3247 or by email at werlingb@bluffton.edu


* Required information
Full Name : *
Gender: *
Preferred Name: *
Email (If you do not have one, please write no email in the box): *
Street address: *
City/State/Zip: *
Home phone: *
Cell phone: *
May we share your email and cell phone with a prospective roommate?: *
Hall Preference : *
Hall Preference : *
I am a: *
Roommate Preference (optional - requests will be honored if space allows and if both roommates list the same preference): *
Smoker: *
Please share with our office any special housing needs you may have: *
What on-campus activities do you plan to be involved in? (Check out our Web site for more info)
Answer:
 Music
 Intramurals
 FCA
 AASO
 Academic/major related club
 Habitat for Humanity
 Ista yearbook
 Theatre
 PEACE Club
  Intercollegiate sports
 Marbeck Center Board
 BASIC
 The Witmarsum
 PALS
 Student Senate
 Radio
 Ministry Teams
 International club
If you listed intercollegiate sports, please list
Answer:
 Baseball
 Football
 Tennis
  Basketball
 Soccer
 Track
  Cross Country
 Softball
 Volleyball
Lifestyle Preferences:
What Kind of relationship do you want with your roommate?
Answer to kind of relationship: *
How do you feel about your roommate using your belongings?
Answer to belongings: *
How often do you clean your room?
Answer to cleaning: *
When does your day begin?
Answer to day begin: *
When does your day end?
Answer to end of day: *
What kind of sleeper are you?
Answer to sleeper: *
How social do you prefer your room to be?
Answer to social: *
With regards to the level of noise in my room when I'm studying, I:
Answer to noise: *
Please check the three types of music you listen to and enjoy most:
Answer to music:
 Alternative
 Country
 Gospel
 New Age
 Punk
  Blues
 Christian
 Indie rock
 Opera
 Rock
  Broadway/Show tunes
 Reggae
 Latin
 Dance/Techno
 R&B
  Classical
 Folk
 Jazz
 Popular/Top 40
 Rap
By submitting this form, I acknowledge that the above information is accurate. I acknowledge the office of residence life will use this information in matching me with a roommate. Further, I am also aware that Bluffton University is a substance free community and a community of respect and I agree to abide by the university's campus standards.
I agree: *